Abstract

MELENDEZ, Héctor Julio; MEDO, Arturo  and  HIGUERA COBOS, Julian. Morbimortality in major hip surgery: A study of the efficacy of selective subarachnoideal spinal anaesthesia compared to balanced general anaesthesia. A controlled clinical trial. Rev. colomb. anestesiol. [online]. 2009, vol.37, n.3, pp.189-201. ISSN 0120-3347.

Objectives: Determining whether early mortality and at six months in elderly patients undergoing hip surgery was related to the type of anaesthesia used. Methods: A controlled clinical trial was designed using 89 patients distributed into two groups. Patients were randomly assigned. Both techniques were standardised and all had an epidural catheter for 48 hrs POP. Morbidity was defined according to CIE X codification and mortality according to death certificate. Immediate post-operative follow-up was carried out in recovery and intrahospital periods until patients were discharged. Telephonic follow-up was continued after one month, the third month and after six months. Results: Mortality was 14.61%, absolute and relative risks being greater in the general anaesthesia group of (20%) cf 9.09% having selective regional anaesthesia, but with no significant differences between them. Causes of death were cardiovascular (10.12%) and infectious aetiology (4.49%), having no differences between groups. 31.57% general morbidity was presented, having greater absolute and relative risks in the group intervened than in the control group, but without significant differences. Conclusions: Early mortality and at six months with general anaesthesia compared to selective regional anaesthesia presented greater absolute and relative risks (20% cf 11.61% RR=2.2), having significant differences between both groups. Greater power is needed for demonstrating significance.

Keywords : arthroplasty; replacement; hip; anesthesia; spinal; general; randomized controlled trial.

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