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Abstract
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Background and Aims In 2023 some # NOF patients who are elderly(>80) were too hypotensive and drowsy for Physiotherapy postoperatively.Side effects due to CNB, include that of sympathetic blockade, such as hypotension in approximately 30% less than baseline or with systolic blood pressure
Methods Retrospective data analysis 2 groups of patients undergoing #NOF:.2 Standard anaesthesia techniques - Spinal anaesthesia with peripheral nerve blocks ( PENG+LFCN/SIFI)-( spinal anaesthesia, 20 mls 0.25% Levobupivacaine usg guided block). Asymptomatic group(control) vs Symptomatic group- symptoms were BP <90 mm hg and inability to mobilise due to drowsiness/agitation. Demographics - All ASA 3&4 patients, >80 Years Data Collected-Pre-, Intra- and postoperative BP hourly. 22 patients identified as too hypotensive or drowsy for Physio, 18 asymptomatic #NOF patients.
Results → Similar Anaesthetic techniques used, ASA 3 & 4 patients in both groups with PNB → More significant HB drop in the hypotensive group Unpaired t test results – HB comparison for the hypotensive and control group The two-tailed P value = 0.2771
Conclusions Introduction of HB check for every patient in Recovery –Haemocue or Venous bloog gas. → Introduction of a Haemocue Sticker to check → Recommend same day FBC HB check for low results on Haemocue and high-risk patients….. 2-3 hours post-op. Communicate with T&O ward team. →Avoid usage of intrathecal opiates in spinals for #NOF patients →Advise following the Prospect Guidelines for tailored postoperative analgesia
day 1 Haemoglobin values
ASA Grades
Spinal anaesthesia drug used