Abstract
The relationship between orthogeriatrician and anaesthetist is fundamental to the continuous provision of medical care from hospital admission through to hospital discharge after hip fracture. Three phases of care define this relationship – preoperative prehabilitation, intraoperative normalisation and postoperative re-enablement. Preoperatively, the aim should be to normalise the patient’s medical condition so that surgery is not delayed. Intra operatively, the anaesthetist should aim to deliver standardised anaesthesia in such a way that a patient is returned to orthogeriatric care postoperatively pain-free and ready for re-enablement. Postoperative care is a continuation of intraoperative re-enablement. Both anaesthetists and orthogeriatricians need to engage in continuous quality improvement programs that aim to reduce hospital and national variations in perioperative care provision for this vulnerable group of patients.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Royal College of Physicians (2014) National hip fracture database extended report 2014. http://www.nhfd.co.uk/20/hipfractureR.nsf/vwcontent/2014reportPDFs/$file/NHFD2014ExtendedReport.pdf?OpenElement. Accessed 1 Apr 2016
White SM, Moppett IK, Griffiths R (2014) Outcome by mode of anaesthesia for hip fracture surgery. An observational audit of 65 535 patients in a national dataset. Anaesthesia 69:224–230
Parker M, Handoll HHG, Griffiths R (2004) Anaesthesia for hip fracture surgery in adults. Cochrane Database of Systematic Reviews (4): CD000521
Luger TJ, Kammerlander C, Gosch M et al (2010) Neuroaxial versus general anaesthesia in geriatric patients for hip fracture surgery: does it matter? Osteop Int 21:S555–S572
Association of Anaesthetists of Great Britain and Ireland (2012) Management of proximal femoral fractures 2011. Anaesthesia 67:85–98
Parker MJ, Griffiths R, Appadu BN (2002). Nerve blocks (subcostal, lateral cutaneous, femoral, triple, psoas) for hip fractures. Cochrane Database of Systematic Reviews (1):CD001159
Dolan J, Williams A, Murney E, Smith M, Kenny GN (2008) Ultrasound guided fascia iliaca block: a comparison with the loss of resistance technique. Reg Anesth Pain Med 33:526–531
White SM. Hip fracture anaesthesia. www.hipfracture.anaesthesia.co.uk. Accessed 1 Apr 2016
Moppett IK, Parker M, Griffiths R, Bowers T, White SM, Moran CG (2012) Nottingham hip fracture score: longitudinal and multi-centre assessment. Br J Anaesth 109:546–550
Marufu TC, White SM, Griffiths R, Moonesinghe SR, Moppett IK (2016) Prediction of 30-day mortality after hip fracture surgery by the Nottingham hip fracture score and the surgical outcome risk tool. Anaesthesia 71:515–521. doi:10.1111/anae.13418. [Epub ahead of print]
White SM, Griffiths R, Moppett I (2012) Type of anaesthesia for hip fracture surgery – the problems of trial design. Anaesthesia 67:574–578
White SM, Moppett IK, Griffiths R et al (2016) Secondary analysis of outcomes after 11,085 hip fracture operations from the prospective UK Anaesthesia Sprint Audit of Practice (ASAP-2). Anaesthesia 71:506–514. doi:10.1111/anae.13415. [Epub ahead of print]
The National Institute of Clinical Excellence. Clinical guideline 124 (2011) The management of hip fracture in adults. http://www.nice.org.uk/nicemedia/live/13489/54918/54918.pdf. Accessed 1 Apr 2016
Scottish Intercollegiate Guidelines Network (2009) Management of hip fracture in older people. National clinical guideline 111. www.sign.ac.uk/pdf/sign111.pdf. Accessed 1 Apr 2016
Wood RJ, White SM (2011) Anaesthesia for 1131 patients undergoing proximal femoral fracture repair: a retrospective, observational study of effects on blood pressure, fluid administration and perioperative anaemia. Anaesthesia 66:1017–1022
Royal College of Physicians and the Association of Anaesthetists of Great Britain and Ireland (2014) National hip fracture database. Anaesthesia sprint audit of practice 2014. http://www.nhfd.co.uk/20/hipfractureR.nsf/4e9601565a8ebbaa802579ea0035b25d/f085c664881d370c80257cac00266845/$FILE/onlineASAP.pdf. Accessed 1 Apr 2016
Sieber FE, Gottshalk A, Zakriya KJ, Mears SC, Lee H (2010) General anesthesia occurs frequently in elderly patients during propofol-based sedation and spinal anesthesia. J Clin Anesth 22:179–183
Ballard C, Jones E, Gauge N et al (2012) Optimised anaesthesia to reduce post operative cognitive decline (POCD) in older patients undergoing elective surgery, a randomised controlled trial. PLoS One 7:e37410
Donaldson AJ, Thomson HE, Harper NJ, Kenny NW (2009) Bone cement implantation syndrome. Br J Anaesth 102:12–22
Griffiths R, White SM, Moppett IK et al; Association of Anaesthetists of Great Britain and Ireland; British Orthopaedic Association; British Geriatric Society. Safety guideline: reducing the risk from cemented hemiarthroplasty for hip fracture 2015: Association of Anaesthetists of Great Britain and Ireland British Orthopaedic Association British Geriatric Society. Anaesthesia 70:623–626
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
White, S.M. (2017). Orthogeriatric Anaesthesia. In: Falaschi, P., Marsh, D. (eds) Orthogeriatrics. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-319-43249-6_7
Download citation
DOI: https://doi.org/10.1007/978-3-319-43249-6_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-43248-9
Online ISBN: 978-3-319-43249-6
eBook Packages: MedicineMedicine (R0)