[Propofol to facilitate spinal anesthesia in the lateral position in patients with femoral neck fracture].

Abstract

PURPOSE:

The aim of this study was to assess the feasibility and efficacy of propofol before positioning elderly patients with a femoral neck fracture in the lateral decubitus position, to perform a spinal anesthetic.

METHODS:

In this prospective and descriptive study, 79 consecutive patients, > 75 yr old, with a femoral neck fracture were included. Propofol, 0.5 mg x kg(-1), was administered. If loss of consciousness was not obtained (Ramsay score < or = 3/6), then additional doses of 0.25 mg x kg(-1) were given until a Ramsay score of 4 or 5 was attained. Then, the patient was turned to the lateral decubitus position, the fractured side up. The efficacy of propofol was assessed by observing a grimace during positioning and asking the patients if they had recall of pain. Hemodynamic data and oxygen saturation were collected.

RESULTS:

Forty-three patients required a single injection, 34 required two injections and only two patients required three injections. No grimace and no recall of pain were recorded during the study. There was no desaturation (SpO(2) < 92 %), and hypotension, defined as a systolic blood pressure decrease > 30% from baseline, was observed.

CONCLUSION:

Propofol is a simple and efficacious means of providing comfort while positioning elderly patients with a femoral head fracture before performing spinal anesthesia.

• Authors: Vincent Minville, Adeline Castel, Karim Asehnoune, Clément Chassery, Jean-Michel Lafosse, Luc Nguyen, Aline Colombani, Olivier Fourcade
• Journal: Canadian journal of anaesthesia = Journal canadien d'anesthesie (Can J Anaesth) Vol. 53 Issue 12 Pg. 1186-9 (Dec 2006) ISSN: 1496-8975 [Electronic] United States
• Vernacular Title: Le propofol pour réaliser une rachianesthésie en position latérale chez les victimes d'une fracture du fémur.
• PMID: 17142652 (Publication Type: Journal Article)

Chemical References

• Hypnotics and Sedatives
• Propofol

Topics

• Aged
• Aged, 80 and over
• Anesthesia, Spinal (methods)
• Blood Pressure
• Conscious Sedation
• Female
• Femoral Neck Fractures (diagnostic imaging)
• Humans
• Hypnotics and Sedatives (administration & dosage)
• Male
• Posture
• Propofol (administration & dosage)
• Ultrasonography