NUMBERS OF FEMUR/HIP FRACTURES IN ELDERLY PEOPLE IN BRAZIL IN THE LAST 10 YEARS AND ANALYSIS OF THE ROLE OF CONTINUOUS SPINAL ANESTHESIA IN THE MANAGEMENT OF PATIENTS WITH HEART PATHS: EPIDEMIOLOGICAL STUDY ASSOCIATED WITH NARRATIVE REVIEW
DOI:
https://doi.org/10.56238/arev8n6-083Keywords:
Femur Fracture, Continuous Spinal Anesthesia, AnesthesiologyAbstract
Population aging has been accompanied by a progressive increase in the incidence of proximal femur fractures in elderly individuals, a condition associated with high morbidity and mortality and significant impact on health systems. In Brazil, the growth of the elderly population in recent decades has contributed to an increase in hospitalizations due to hip fractures, which are often associated with osteoporosis, frailty, and low-energy falls. These patients frequently present multiple comorbidities, especially cardiovascular diseases, which increase perioperative risk and make the choice of anesthetic technique a relevant factor in surgical management. In this context, continuous spinal anesthesia has been proposed as a potentially advantageous alternative compared with other anesthetic techniques, due to the possibility of progressive titration of the intrathecal anesthetic and greater hemodynamic stability during the procedure. The present study aimed to review the scientific literature on proximal femur fractures in elderly patients in Brazil over the last ten years and to analyze the impact of continuous spinal anesthesia on the morbidity and mortality of patients with comorbid heart disease undergoing surgery for the correction of these fractures. A literature review was conducted based on observational studies, randomized clinical trials, systematic reviews, and meta-analyses. Overall, the studies demonstrate an increase in hip fractures associated with population aging and indicate that general anesthesia and regional anesthesia present similar outcomes regarding mortality. However, evidence suggests that neuraxial techniques, particularly continuous spinal anesthesia, may provide greater hemodynamic stability and a potential reduction in some perioperative complications in elderly patients with cardiovascular comorbidities. It is concluded that continuous spinal anesthesia represents a promising alternative in the anesthetic management of these patients, although further studies are needed to confirm its impact on clinical morbidity and mortality outcomes.
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References
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