Anaesthesia for repair of fractured neck of femur. A comparison of spinal and general anaesthesia

McKenzie, Peter John (1984) Anaesthesia for repair of fractured neck of femur. A comparison of spinal and general anaesthesia. MD thesis, University of Glasgow.

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Patients having repair of fractured neck of femur are one of the highest risk groups commonly presenting for anaesthesia and the incidence of fractured neck of femur is rising almost alarmingly. Patients are generally very elderly and pre-operative medical problems are extremely common. Great demands are placed on health care resources and post-operative morbidity and mortality are high. The choice of anaesthetic technique lies mainly between conventional general anaesthesia (GA) or some form of regional anaesthesia, of which sub-arachnoid block (SAB), otherwise referred to as "spinal" anaesthesia, is probably the most appropriate. Many anaesthetists feel that spinal anaesthesia is superior to general anaesthesia for the patient with fractured neck of femur and the present thesis attempts to compare and assess objectively some aspects and effects of these anaesthetic techniques in patients having repair of fractured neck of femur. Sub-arachnoid spinal anaesthesia was compared with conventional general anaesthesia in respect of effects on respiratory function in the immediate peri-operative period, incidence of post-operative deep venous thrombosis and peri-operative changes in blood viscosity and its determinants. Comparative results are presented of mortality and outcome over the year following operation. An analysis of the relative merits of the two anaesthetic techniques is attempted and the influence of practical as well as theoretical factors assessed. The dangers of drawing conclusions from short term follow up is clearly demonstrated. The author considers that, contrary to the opinion currently held by many anaesthetists and despite the specific advantages of spinal anaesthesia demonstrated in this thesis, general anaesthesia is the preferable method of anaesthesia for repair of fractured neck of femur. Spinal anaesthesia should continue to be taught and reserved for those patients for whom it should offer particular benefits. (Abstract shortened by ProQuest.).

Item Type: Thesis (MD)
Qualification Level: Doctoral
Additional Information: Adviser: Professor Alastair Spence.
Keywords: Medicine, surgery, anaesthesia.
Subjects: R Medicine > RD Surgery
Colleges/Schools: College of Medical Veterinary and Life Sciences
Date of Award: 1984
Depositing User: Enlighten Team
Unique ID: glathesis:1984-71593
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 17 May 2019 09:31
Last Modified: 27 Oct 2022 14:19
Thesis DOI: 10.5525/gla.thesis.71593
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