Anesthetic management of the elderly patients with femoral neck fracture by sevoflurane and femoral nerve block Masui. 2000 Jun;49(6):630-3.
Takahiro Fujimoto MD
Department of Anesthesia, Tokyo Metropolitan Geriatric Hospital.
Fracture of the femoral neck (FNF) is a significant cause of morbidity and mortality in the elderly, and the elderly with FNF are often high-risk patients for anesthesia. We studied 15 patients above 80 years of age with severe physical status (ASA III-IV). After femoral nerve block (for the pain of fracture) and lateral femoral cutaneous nerve block (for the cutting pain), surgical procedure was performed under general anesthesia by laryngeal mask airway under spontaneous ventilation. After the operation, morphine 2 mg was administered subcutaneously. In our experience, the majority of 15 patients cardiovascular status of remained stable, except one patient who needed ephedrine for hypotension and another patient who needed diclofenac sodium for post-operative pain relief.