Successful anesthesia and hip surgery in a 107-year-old patient

Abstract

Patient: Female, 107Final Diagnosis: Hip fractureSymptoms: —Medication: —Clinical Procedure: Hip surgerySpecialty: Orthopedics and TraumatologyObjective:Rare diseaseBackground:In modern societies, elderly populations have increased over the last four decades and have become the main clients of medical services. A hip fracture is a significant injury for anyone, but for older people it can be catastrophic.Case Report:A 107-year-old female was admitted with fracture of the right hip. The patient took a single 200 mL carbohydrate drink orally two hours before surgery. Before induction of spinal anesthesia, routine monitoring was started and an intravenous line was placed. Crystalloids and hydroxyethyl starch in 0.9% sodium chloride solution were administered intravenously during the operation. After sedation with i.v. ketamine and midazolam, spinal puncture was performed with the patient in the sitting position and isobaric bupivacaine were administered. The level of sensory block was observed in T12 and motor blockade (grade 3) of the lower limbs. The surgical procedure lasted 60 minutes without hypotension, bradycardia or decreased oxygen saturation. For safety reason, the patient was transferred to the ICU for monitoring; intravenous hydration was withdrawn and released oral feeding six hours after the end of surgery. The patient was sent to his residence on the morning of the second day.Conclusions:This case showed that with suitable techniques and conduits can perform surgery in a patient with 107 years.

Attitudes, awareness and barriers regarding evidence-based orthopedic surgery between health professionals from a Brazilian Public Health System (SUS) hospital: Study of 400 patients

“…[ 3 4 ] We have reported a reduced length of stay, number of suspension, the duration of fasting, the release the feedback, the length of stay in the postanesthetic care unit (PACU), and incidence of hypotension in elderly patients undergoing chip surgery and who received fast-track perioperative care. [ 5 6 7 8 9 ]…”

Successful treatment of an open tibial fracture in a 102-year-old woman: a case report

“…The medical evaluation for patients with advanced ages should focus on identifying risk factors, optimizing status, predicting complications, and providing appropriate information. Some studies have described cases of surgery in patients aged >100 years, for example, coronary bypass surgery in a 105-year-old patient 3) , abdominal wall reconstruction in a 105-year-old patient 4) , and osteosynthesis for hip fracture in a 107-year-old patient 5) . They reported that in each case, detailed risk assessment, surgical planning, and meticulous postoperative management were the reasons for the successful surgical treatment [3][4][5] .…”

A Novel Approach for Treatment of Acetabular Fractures

“…The blood loss in PSA is comparable to that of other approaches [ 16 ]. It is acknowledged that the blood loss is more dependent on patient factors such as the severity of the acetabular fracture, associated injuries, coagulability, and bone bleeding [ 6 , 8 , 16 , 23 ], and it does not affect the outcome score [ 6 ]. In a hip fracture, the blood loss could exceed one liter.…”

“…In a hip fracture, the blood loss could exceed one liter. In such cases, a less invasive incision is preferred [ 23 ]. Moreover, prolonged traumatic surgical dissection is known to increase the incidence of heterotopic ossification [ 8 ].…”