Special Anesthetic Consideration for the Patient with a Fragility Fracture

Abstract

Synopsis This article presents an overview of perioperative management of the fragility fracture patient including, pre-operative risk stratification and optimization, anesthesia risks and anesthesia options as well as post-operative pain management. It is the intent of this manuscript to communicate the issues of preoperative evaluation which are of concern for the anesthesiologist because of their direct effect on intraoperative care. A team interdisciplinary approach and good communication between specialties involved in care of the elderly surgical patients is important for optimal patient outcomes and to avoid perioperative complications. Cooperation between anesthesiology and medicine is indispensable in reaching a reasonable consensus regarding preoperative evaluation, and should occur on a case-by-case basis.

The use of echocardiography as a routine perioperative monitoring standard: The perspective of a cardiothoracic anesthesiologist

“…Anesthetic agents such as propofol, ketamine, opioids, inhalation anesthetic agents, and many others, can directly affect the cardiovascular system. 2 While the major cardiac event occurred during perioperative events is also quite high. Especially for the patients in the perioperative period who will undergo non-cardiac surgery.…”

Focus on co-management in geriatric fracture care

“…Due to the osteopenic bone structure even minimal trauma leads to sometimes complex fractures of a type rarely found in younger patients [10]. Implant fixation in osteoporotic bone presents a dilemma for the orthopaedic surgeon and lead to the development of new fixation techniques [11].…”