Key result
General anesthesia with femoral nerve block yielded more stable mean arterial blood pressure after induction (P=0.04) and post cement implantation (P=0.038) compared to spinal anesthesia.
Why the study?
General anaesthesia versus spinal anaesthesia is still debated as the best anaesthetic method for cemented hip arthroplasty in elderly adults.
Does general anesthesia combined with femoral nerve block improve mean arterial blood pressure stability compared to spinal anesthesia in elderly patients undergoing cemented hip arthroplasty?
RCT (n=60)
randomized
No
Does general anesthesia combined with femoral nerve block improve mean arterial blood pressure stability compared to spinal anesthesia in elderly patients undergoing cemented hip arthroplasty?
p-value: p=0.04 and 0.038
General anesthesia combined with femoral nerve block provides better hemodynamic stability than spinal anesthesia in elderly patients undergoing cemented hip arthroplasty.
Supports general anesthesia with femoral nerve block for MAP stability in elderly cemented hip arthroplasty; extends RCT evidence guiding anesthesia selection.
BACKGROUND Traumatic femoral fractures are a prevalent orthopaedic issue in elderly adults. General anaesthesia (GA) vs. spinal anaesthesia are still being discussed as the best anaesthetic method for cemented hip arthroplasty (SA). This study compared the impact of spinal anaesthesia versus general anaesthesia in combination with femoral nerve block on the mean arterial blood pressure (MAP) in patients having cemented hip arthroplasty operations.AIM OF THE STUDY To compare the impact of spinal anaesthesia on elderly patients undergoing cemented hip arthroplasty operations versus general anaesthesia in combination with femoral nerve block on mean arterial blood pressure.PATIENTS AND METHODS The study was registered at Pan African-Clinical Trial Registry.org with ID of (PACTR 202,111,575,647,784). At Ain Shams University Hospital, 60 patients receiving total hip arthroplasty were separated into two equal groups, each comprising 30 patients, for the purpose of this prospective randomised comparison study. Patients in Group (A) underwent spinal anaesthesia, while Group (B) received general anaesthesia together with an ultrasound-guided femoral nerve block.RESULTS This study showed that GA was associated with more stable readings of mean arterial blood pressure (MAP) after anesthesia induction and post cement implantation than SA (p-value = 0.04 and 0.038 respectively).CONCLUSION Patients who received general anesthesia (GA) had more stable hemodynamic parameters especially the mean arterial blood pressure (MAP) than those who received spinal anesthesia (SA).
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Abdelrahman et al. (2023) conducted an RCT in Traumatic femoral fractures requiring cemented hip arthroplasty (n=60). General anesthesia in combination with femoral nerve block vs. Spinal anesthesia was evaluated on Mean arterial blood pressure (MAP) after anesthesia induction and post cement implantation (p=0.04 and 0.038). General anesthesia with femoral nerve block yielded more stable mean arterial blood pressure after induction (P=0.04) and post cement implantation (P=0.038) compared to spinal anesthesia.
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