Hatice TÜRE, Aslıhan USLUER, Zeynep ETİ, Doğan İ. VARLIK, F. Yılmaz GÖĞÜŞ

The effect of anaesthetic technique on postoperative venous thromboembolism in elderly patients undergoing total hip replacement

Amaç: Yaşlı hastalarda sık görülen travmatik kalça kırığının major tedavisi total kalça protezidir. Ancak bu girişim venöz tromboemboli gibi belirgin postoperatif komplikasyonlara neden olabilir. Bu çalışmada travmatik kalça kırığı nedeniyle total kalça protezi operasyonu geçiren yaşlı hastalarda postoperatif dönemde morbidite ve mortaliteyi arttıran bir komplikasyon olan venöz tromboemboli görülme sıklığının uygulanan anestezi yöntemiyle ilişkisi retrospektif olarak incelenmiştir. Gereç ve Yöntem: Kliniğimizde 1997-2003 tarihleri arasında 65 yas uzeri, travmatik kalça kırığı nedeniyle total kalça protezi operasyonu geçiren 65 yas ustu hastalarin kayitlari incelenmistir. Hastalarin demografik özellikleri, intraoperatif ve postoperatif bulguları, venöz tromboemboli görülme sıklığı ve anestezi yontemi ile ilişkisi incelenmiştir. Bulgular: 291 hastanın %10.8’inde postoperatif venöz tromboemboli tesbit edilmiştir. Genel anestezi sonrası tromboemboli sıklığı %10.5 iken, epidural anestezi sonrası %9.2 olarak belirlenmiştir (p>0.05). Sonuçlar: Çalışmamızda venöz tromboemboli sıklığı ile cerrahi sırasında uygulanan anestezi yöntemi arasında bir ilişki belirlenemese de, epidural anestezinin daha az kan kaybı ve daha az kan transfüzyonuna neden olduğu saptanmıştır. Ayrıca venöz tromboemboli görülme sıklığının yaş ve cerrahi süre ile orantılı olarak arttığı belirlenmiştir.

Yaşlı hastalarda anestezi yönteminin total kalça protezi sonrası derin ven trombozuna etkisi

Background: Because hip fractures are common in elderly patients, total hip replacement has been a major advancement in treatment. This procedure, however, is associated with significant postoperative complications such as venous thromboembolism. In this study we retrospectively analyzed the factors affecting the incidence of venous thromboembolism complication which is related with the postoperative morbidity and mortality and its relation with the type of anaesthesia in elderly patients undergoing total hip replacement for traumatic hip fracture. Materials and Methods: We retrospectively reviewed the data of patients aged more than 65 years old, who have undergone total hip replacement after traumatic hip fracture at our institution between 1997 and 2003. The data included patients’ demographic characteristics, intraoperative and postoperative findings, venous thromboembolism incidence and its relation with anesthetic technique. Results: Venous thromboembolism was diagnosed in 10.8% of 291 patients. The incidence of venous thromboembolism was 10.5% after general anaesthesia and 9.2% after epidural anaesthesia (p>0.05). Conclusions: We found no association between the incidence of venous thromboembolism and the type of anaesthesia, although there were some advantages such as less blood lost and fewer blood transfusions with epidural anaesthesia. However, a significant correlation was found between venous thromboembolism and the patient’s age and duration of surgery.

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