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Regional Anesthesia and Hip Repair
2 Minute EBP Challenge
Stay up-to-date the easy way!
How would you answer this question?
Using regional anesthesia in the repair of hip fractures results led to what outcome?
a. 9% reduction in in-hospital morality
b. Greater chance of refracture or dislocation
c. Fewer pulmonary complications
d. Increased cardiovascular events
The correct answer is "c" fewer pulmonary complications.
Repair of a fractured hip using general anesthesia is fraught with complications, most notably pulmonary atelectasis, infection and respiratory failure. In this study, the authors examined using regional anesthesia instead of general anesthesia for hip fracture repair. Previous small studies suggested a benefit in complications and mortality.
The authors found a 29% decrease in overall in-hospital mortality, a 24% decrease in pulmonary complications, and a significant decrease in respiratory failure. Cardiovascular events were similar with regional and general anesthesia.
This study suggests an exciting alternative for older patients needing hip surgery and also points out the numerous complications that are inherent to a large complicated surgery such as hip repair. If your patient is having surgery, make sure to provide excellent pulmonary hygiene: coughing, deep breathing, incentive spirometry, adequate fluid intake, turning, positioning, and ambulation.
From: Neuman M, et al. (2012). Comparative effectiveness of regional versus general anesthesia for hip fracture surgery in adults. Anesthesiology; DOI: 10.1097/ALN.0b013e3182545e7c.
Congratulations to Lisa Guy who won an autographed copy of my 101 Tips to Improve Your Nursing Care book for answering this week's question Lisa correctly. Congratulations !
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David W. Woodruff, MSN, RN-BC, CNS, CMSRN, CEN
President, Ed4Nurses, Inc.
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