NÚMERO DE FRACTURAS DE FÉMUR/CADERA EN ANCIANOS EN BRASIL EN LOS ÚLTIMOS 10 AÑOS Y ANÁLISIS DEL PAPEL DE LA ANESTESIA ESPINAL CONTINUA EN EL MANEJO DE PACIENTES CON TRAYECTORES CARDÍACOS: ESTUDIO EPIDEMIOLÓGICO ASOCIADO A LA REVISIÓN NARRATIVA
DOI:
https://doi.org/10.56238/arev8n6-083Palabras clave:
Fractura de Fémur, Anestesia Espinal Continua, AnestesiologíaResumen
Population aging has been accompanied by a progressive increase in the incidence of fractures of the proximal femur in the elderly, a condition associated with high morbidity and mortality and a significant impact on health systems. En Brasil, el crecimiento de la población anciana en las últimas décadas ha contribuido al aumento de las hospitalizaciones por fracturas de cadera, a menudo asociadas con osteoporosis, fragilidad y caídas de baja energía. Estos pacientes suelen presentar múltiples comorbilidades, especialmente enfermedades cardiovasculares, que aumentan el riesgo perioperatorio y hacen que la elección de la técnica anestésica sea un factor relevante en el manejo quirúrgico. En este contexto, la anestesia espinal continua se ha propuesto como una alternativa a otras técnicas anestésicas más agresivas, debido a la posibilidad de una titulación progresiva del anestésico intratecal y una mayor estabilidad hemodinámica durante el procedimiento. El presente estudio tuvo como objetivo revisar la literatura científica sobre fracturas de fémur en ancianos en Brasil durante los últimos diez años y analizar el impacto de la anestesia espinal continua en la morbilidad y mortalidad de pacientes con enfermedades cardíacas comórbidas sometidos a cirugía para corregir esas fracturas. Foi realizó una revisión de la literatura con base en estudios observacionales, ensayos clínicos aleatorios, revisiones sistemáticas y metaanálisis. En general, los estudios demuestran un aumento de fracturas de cadera asociado al envejecimiento de la población e indican que la anestesia general y la anestesia regional presentan resultados similares en relación a la mortalidad. Sin embargo, la evidencia sugiere que las técnicas neuroaxiales, especialmente la anestesia espinal continua, pueden proporcionar una mayor estabilidad hemodinámica y una reducción potencial de algunas complicaciones perioperatorias en pacientes ancianos con enfermedades cardíacas. Se concluye que la anestesia espinal continua representa una alternativa en el manejo anestésico de estos pacientes, aunque son necesarios más estudios para confirmar su impacto en los resultados de morbimortalidad clínica.
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