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Orthopaedic anaesthesia in the elderly 

Orthopaedic anaesthesia in the elderly
Chapter:
Orthopaedic anaesthesia in the elderly
Author(s):

Richard Griffiths

DOI:
10.1093/med/9780199604999.003.0020
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date: 18 August 2019

This chapter reviews one of the most common areas of anaesthetic practice in the elderly. It is divided into elective and emergency sections and identifies that these broadly relate to the two major bone disorders—osteoarthritis and osteoporosis—in the elderly. The majority of elective surgery is for joint replacement and it describes the national registries for arthroplasties and then deals with primary hip and knee replacement and their revision procedures. Emergency orthopaedic surgery resulting from falls or as fragility fractures is becoming more prevalent. Vertebroplasty is reviewed and the lack of evidence is highlighted as well as the claimed benefit. Fractures of the proximal femur are identified as a benchmark condition for care of the elderly. It reviews the evidence on the assessment, comorbidities, and timing of surgical care. It also comments on the regional/general anaesthetic choices and on pain control and blood replacement.

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