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Case Report

Anesthetic Management of Bilateral Neck of Femur Fracture for Bilateral Hip Arthroplasty with CKD and Seizure Disorder

N Kiran null, Sai Yashaswini Gorle1 null, N Kiran2 null, Shri Eshwari3 null, Sujatha M P4 null, Ravi M5 null

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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

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Indian Journal of Anesthesia and Analgesia 9(5):p 239-241, September-October 2022. | DOI: https://doi.org/10.21088/ijaa.2349.8471.9522.4

How Cite This Article:

How to cite this article: Sai Yashaswini Gorle, N Kiran, Shri Eshwari, et. al./Anesthetic Management of Bilateral Neck of Femur Fracture for Bilateral hip Arthroplasty with Ckd and Seizure Disorder/Indian J Anesth Analg. 2022;9(5)239-241.

Timeline

Received : May 26, 2022         Accepted : June 28, 2022          Published : October 10, 2022

Abstract

In elderly hip fractures are common presentations which require surgical intervention. These patients have increased morbidity and mortality due to associated comorbidities like renal, cardiac, respiratory, endocrine or neural diseases. Chronic kidney disease is one of the common complications of long standing uncontrolled hypertension and diabetes mellitus. Patients with CKD are exposed to an increased risk for adverse outcomes and further perioperative injuries resulting from hemodynamic instability, hypovolemia, or drug toxicity, each of which has the potential to aggravate renal dysfunction, ultimately leading to end stage renal disease, and reduced long-term survival. It is estimated that there are approximately 7.85 million chronic renal failure patients in India.1 Diabetes mellitus and hypertension reaching epidemic proportion in urban population and chronic kidney disease being inevitable in long standing untreated cases, providing anesthesia to patients with chronic kidney disease poses a challenge.

Case Report: A 48yr old male presented with bilateral neck of femur fracture following fall from height and was planned for bilateral hip arthroplasty. Patient is a known case of CKD on maintenance haemodialysis. He is also a known hypertensive, diabetic and seizure disorder on treatment. Patient has underwent epidural anesthesia.

Conclusion: We present a successful anesthetic management of a dwarf patient with bronchial asthma and hypothyroidism who underwent hysterectomy. We emphasize the risk of neurological injury while extending the neck during laryngoscopy for tracheal intubation due to anatomical abnormalities in these patients. A detailed pre anesthetic evaluation evaluation and planning is utmost important and the anesthetic technique has to be individualized based on the patients anatomical characterstics and associated co-morbidities.

 

References

  • 1.   Chandrappa H.N, Hemanth Kumar J. “Regional Anesthesia - Anesthesia of Choice in Chronic Kidney Disease”. ; Page: 1085-88
  • 2.   Murakami M, Nomiyama S, Ozawa A, Matono H, Tanabe H, Watanabe S. Anesthetic management of pediatric renal transplantation for chronic renal renal failure. Masui 1993; 42(2):263-70.
  • 3.   Garwood S. Renal disease. In: Hines RL, Marschall KE, editors. Anesthesia and Co-Existing Disease. 5th ed. Philadelphia: Churchill Livingstone; 2014;2(5) 323-47.
  • 4.   Sharrock NE, Beksac B, Flynn E, Go G, Valle GD. Hypotensive epidural anesthesia in patients with
  • 5.   Ranawat CS, Beaver WB, Sharrock NE, Maynard MJ, Urquhart B, Schneider R. Effect of hypotensive epidural anesthesia on acetabular cement-bone fixation in total hip arthroplasty. J Bone Joint Surg [British] 1991; 73(B);779–82

Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.

About this article

Cite this article

How to cite this article: Sai Yashaswini Gorle, N Kiran, Shri Eshwari, et. al./Anesthetic Management of Bilateral Neck of Femur Fracture for Bilateral hip Arthroplasty with Ckd and Seizure Disorder/Indian J Anesth Analg. 2022;9(5)239-241.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.

Received Accepted Published
May 26, 2022 June 28, 2022 October 10, 2022
DOI: https://doi.org/10.21088/ijaa.2349.8471.9522.4

Keywords

CKD; Spinal anesthesia; neck of femur fracture.

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Timeline

Received May 26, 2022
Accepted June 28, 2022
Published October 10, 2022

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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