[Perioperative Management of Elderly Patients Over 90 Years of Age with Femoral Neck/Trochanteric Fracture].

BACKGROUND

The use of anesthesia in patients older than 90 years has been increasing. We examined the perioperative management of these patients.

METHODS

The perioperative complications, waiting period for surgery, method of anesthesia, and prognosis in patients older than 90 years undergoing operations for femoral neck/trochanteric fractures were retrospectively examined in our anesthesia database.

RESULTS

The average age of patients was 94.0±2.8 years. All patients had preoperative complications, including hypertensive disease (91.7%), renal dysfunction, anemia, or dementia. The average waiting period for surgery was 3.7±2.1 days; 92.6% of the patients underwent surgery within 7 days and 40.7% within 2 days. The main reason for waiting was withdrawal of antiplatelet and anticoagulant drugs. Local anesthesia, including spinal and epidural anesthesia, was used in 77.8% of patients. General anesthesia was selected for those patients on hemodialysis and continuous antiplatelets/anticoagulants. Hypotension was observed in 63.0% of the patients. The postoperative course was satisfactory, with the exception of 2 patients who died within 3 months from pneumonia and heart failure, respectively.

CONCLUSIONS

Anesthetic management of the patients was without major complications. Anesthesia, either general or local, was performed safely. Further study of the relative advantages of anesthetic methods is required.