Comparison of General Anesthesia and Spinal Anesthesia on Postoperative Myocardial Injury in Elderly Hip Surgery Patients

What this Trial Is About

Researchers are investigating how general anesthesia and spinal anesthesia affect the risk of myocardial injury after hip surgery in elderly patients. This study focuses on myocardial injury after non-cardiac surgery (MINS), a condition marked by silent increases in troponin levels without ECG changes, which is linked to higher postoperative mortality. As cardiovascular events remain the leading cause of death following non-cardiac surgeries, understanding anesthesia's role in preventing MINS is important, especially given the aging population and rising surgery rates among older adults. Participants will be randomly assigned to receive either general anesthesia or spinal anesthesia during their hip surgery. General anesthesia involves medications like fentanyl, propofol, rocuronium, sevoflurane, and remifentanil, with mechanical ventilation and postoperative pain control using tramadol and paracetamol. Spinal anesthesia includes a spinal injection of hyperbaric bupivacaine to numb the lower body, with surgery starting once sufficient sensory block is confirmed. If spinal anesthesia is inadequate, patients may switch to general anesthesia. Throughout the study, participants will be monitored for myocardial injury by measuring troponin levels before surgery and up to 72 hours afterward. Secondary outcomes include the length of intensive care unit and hospital stays up to 90 days. Patients will undergo assessments such as sensory block testing and recovery scoring, with safety and recovery carefully tracked. The study lasts through the surgical and postoperative periods, focusing on heart health and recovery in elderly hip surgery patients.

The Effects of General Versus Spinal Anesthesia on Postoperative Myocardial Injury