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The objective of this study was to investigate the difference in postoperative pulmonary complications (PPCs) between spinal anesthesia and general anesthesia in patients undergoing delayed hip surgery.
In this study, the difference of 30 min arterial partial pressure of oxygen after operation was used as the main outcome index. By means of pulmonary ultrasound, pulmonary function monitoring and other physical and biochemical examinations, the difference of postoperative pulmonary complications between spinal anesthesia and general anesthesia in patients with delayed operation of hip fracture longer than 48 hours was compared.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| spinal anesthesia | Experimental | Patients underwent real-time ultrasound guided spinal anesthesia. The maximum attempts of skin piercings are 3, and the total redirections of each skin piercings should not exceed 6 times. General anesthesia was considered if three skin piercings were unsuccessful. |
|
| general anesthesia | Experimental | Rapid sequential induction was performed with sufentanil 0.5 ug /kg, etomidate 0.3 mg /kg, cisatracurium 0.15 mg /kg, and then laryngeal mask was applyed. Parameter settings: tidal volume: 6-10 mL/kg, 1.5 ~ 2.0% sevoflurane inhalation, remifentanil 0.1 ~ 0.2 ug/ kg.min-1. Mechanical driving pressure was applyed by PEEP titration method. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| spinal anesthesia | Procedure | An intrathecal anesthetic technique. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Arterial partial pressure of oxygen, PaO2 | PaO2 was measured by arterial blood gas analysis | 30 minutes after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Arterial partial pressure of oxygen, PaO2 | PaO2 was measured by arterial blood gas analysis | 30 minutes before surgery |
| Forced vital capacity, FVC | FVC was measured by Spirometer (SP70B) |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse outcomes | Documented side effects associated with the intervention by an unwitting third party | up to one month |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tianzhu Liu, M.D. | Contact | 13098866448 | liutzh@126.com |
| Name | Affiliation | Role |
|---|---|---|
| Tianzhu Liu, M.D. | Tongji Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tianzhu Liu | Recruiting | Wuhan | Hubei | 430000 | China |
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| ID | Term |
|---|---|
| D006620 | Hip Fractures |
| ID | Term |
|---|---|
| D005264 | Femoral Fractures |
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D025981 | Hip Injuries |
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| ID | Term |
|---|---|
| D000775 | Anesthesia, Spinal |
| D000768 | Anesthesia, General |
| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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| general anesthesia | Procedure | An intravenous (combined with inhalation) anesthetic technique. |
|
| 30 minutes before surgery; 30 minutes after surgery; 24 hours after surgery |
| Forced expiratory volume in 1 second, FEV1 | FEV1 was measured by Spirometer (SP70B) | 30 minutes before surgery; 30 minutes after surgery; 24 hours after surgery |
| Peak expiratory flow, PEF | PEF was measured by Spirometer (SP70B) | 30 minutes before surgery; 30 minutes after surgery; 24 hours after surgery |
| PEF 25, 75, and 25-75 | PEF 25, 75, and 25-75 were measured by Spirometer (SP70B) | 30 minutes before surgery; 30 minutes after surgery; 24 hours after surgery |
| Lung Ultrasound Score (LUS) | Bedside measurements using portable ultrasound | 30 minutes before surgery, 30 minutes after surgery, 24 hours after surgery |
| Postoperative pulmonary complications | Pulmonary complications (PPCs) include: (1) Evidence of pneumonia, pneumothorax, atelectasis and pleural effusion indicated by postoperative pulmonary ultrasound, chest film or chest CT; ② After surgery, the patient developed bronchospasm, ARDS, O2 requirement (nasal catheter or mask), non-invasive ventilation requirement, or unplanned endotracheal intubation/mechanical ventilation for more than 1 day; ③ The increase of inflammatory biochemical indexes 24 h after surgery suggested systemic inflammatory response (blood routine, C-reactive protein CRP, procalcitonin PCT and IL-6, IL-1β, TNF-α). | up to one month |
| Hip mobility (Harris hip score, HHS) | The Harris scale was used to score. Range:0-100. A total Harris hip score below 70 points was considered a poor result, 70 to 80 fair, 80 to 90 good, and 90 to 100 excellent. | up to one month |
| D007869 |
| Leg Injuries |