Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Luiz Eduardo Imbelloni, Umberto Lima, Francisco Kartney Pedrosa
(Department of Anesthesiology, Faculdade de Medicina Nova Esperança, João Pessoa, Brazil)
Am J Case Rep 2014; 15:308-311
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 For safety reason, the patient was transferred to the ICU for monitoring; intravenous hydration was withdrawn and released oral feeding six hours after the end of surgery.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
Keywords: Anesthesia, Spinal - methods, Aged, 80 and over, Anesthetics, Local - administration & dosage, Female, Fracture Fixation - methods, Hip Fractures - surgery, Humans, Pain Measurement