Hip fractures are a common, morbid, and costly event among older adults. Patients with hip fractures are typically operated on within 24 hours of admission. However, they typically present multiple comorbidities that may not be easily controlled before the needed hip surgery.

For these reasons, spinal anesthesia is usually the best anesthetic option, where not contraindicated by anticoagulation or the presence of neurologic symptoms. Expertly performed spinal anesthesia results in a more stable perioperative course than general anesthesia. More importantly, spinal anesthesia decreases inpatient mortality and pulmonary complications (Neuman MD, Anesthesiology 2012, Vol. 117, 72–92).

In this video, Dr. Hadzic describes NYSORA’s standardized anesthetic management of patients with hip fractures, which consists of a suprainguinal fascia iliaca block, and lowdose isobaric spinal with bupivacaine with the paramedian technique.

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