Anaesthetic techniques for surgical correction of fractured neck of femur

Surgical correction of fractured neck of femur in the elderly is a procedure associated with a high post-operative morbidity and mortality.Recent surveys indicate varying post-operative mortality rates from 7-22% within 6 weeks of operation.Various pre-operative indices have been quoted as having an adverse effect on the chances of survival, in particular the age and sex of the patient, the pre-injury activity level, and the blood urea level but seldom if at all has anaesthetic technique been questioned as having a significant bearing on post-operative survival.It was decided therefore to compare two groups of patients, one given a standard general anaesthetic and the other a unilateral spinal block combined with basal sedation. MaterialFifty-five patients presenting for surgical correction of fractured neck of femur were seen by the authors and their acceptability for anaesthesia assessed.A case history was obtained from each patient and this was followed by physical examination.Laboratory investigations undertaken included full blood count, urea and electrolytes, blood gases, chest X-ray and electrocardiogram (ECG).If considered suitable for operation the patients were then randomly allocated to one of the two anaesthetic techniques.