Spinal Versus General Anesthesia on Postoperative Pulmonary Complications

Tongji Hospital

Status: Enrolling

Conditions: Hip Fractures; Pulmonary Complication; Anesthesia

Treatments: Procedure: general anesthesia; Procedure: spinal anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT06425627

TongjiHospital102114

Details and patient eligibility

About

The objective of this study was to investigate the difference in postoperative pulmonary complications (PPCs) between spinal anesthesia and general anesthesia in patients undergoing delayed hip surgery.

Full description

In this study, the difference of 30 min arterial partial pressure of oxygen after operation was used as the main outcome index. By means of pulmonary ultrasound, pulmonary function monitoring and other physical and biochemical examinations, the difference of postoperative pulmonary complications between spinal anesthesia and general anesthesia in patients with delayed operation of hip fracture longer than 48 hours was compared.

Enrollment: 40 estimated patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients ≥ 65 years old
• ASA Class I ~ III
• Surgical repair of femoral neck, intertrochanteric or subtrochanteric fractures
• The time from diagnosis to surgery is more than 48 hours

Exclusion criteria

• Unable to walk about 3 meters or across a room without assistance before the fracture
• Emergency surgery
• Congestive heart failure, asthma, anemia (Hb < 90 g/L), hypoalbuminemia (ALB < 35g/L)
• Abnormal coagulation function
• Severe aortic stenosis
• Injection site infection or increased intracranial pressure
• Patients have participated in previous trials or have been determined by a surgeon or anesthesiologist to be unsuitable for randomization
• The written informed consent of the patient or his/her representative cannot be obtained

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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40 participants in 2 patient groups

spinal anesthesia

Experimental group

Description:

Patients underwent real-time ultrasound guided spinal anesthesia. The maximum attempts of skin piercings are 3, and the total redirections of each skin piercings should not exceed 6 times. General anesthesia was considered if three skin piercings were unsuccessful.

Treatment:

Procedure: spinal anesthesia

general anesthesia

Experimental group

Description:

Rapid sequential induction was performed with sufentanil 0.5 ug /kg, etomidate 0.3 mg /kg, cisatracurium 0.15 mg /kg, and then laryngeal mask was applyed. Parameter settings: tidal volume: 6-10 mL/kg, 1.5 \~ 2.0% sevoflurane inhalation, remifentanil 0.1 \~ 0.2 ug/ kg.min-1. Mechanical driving pressure was applyed by PEEP titration method.

Treatment:

Procedure: general anesthesia