a (HUSA) to general anesthesia (GA) in patients ≥70 years of age undergoing hip fracture surgery. METHODS: We conducted a single-center, prospective, randomized study. In the HUSA group, patients were positioned with the operated hip above, and the hypobaric anesthetic solution was composed of 9 mg ropivacaine, 5 µg sufentanil, and 1 mL of sterile water. Anesthesia was adjusted for the GA group. Mean arterial pressure (MAP) was measured with a noninvasive blood pressure upper arm cuff every 3 minutes. Hypotension was treated with a bolus of ephedrine and then a continuous intravenous of norepinephrine to obtain a MAP ≥65 mm Hg. Primary outcome was the occurrence of severe hypotension, defined as a MAP <65 mm Hg for >12 consecutive minutes. RESULTS: A total of 154 patients were included. Severe hypotension was more frequent in the GA group compared to the HUSA group (odds ratio, 5.6; 95% confidence interval, 2.7–11.7; P < .001). There was no significant difference regarding the short-term outcomes between the HUSA and GA groups: acute kidney injury (respectively, 5.1% vs 11.3%; P = .22), myocardial injury (18.0% vs 14.0%; P = .63), and 30-day mortality (2.4% vs 4.7%; P = .65). CONCLUSIONS: HUSA leads to fewer episodes of severe intraoperative hypotension compared to GA in an elderly population undergoing hip fracture surgery....

中文翻译：

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低压单侧脊髓麻醉与全身麻醉用于老年人髋部骨折手术：随机对照试验

a 对于年龄≥70 岁接受髋部骨折手术的患者，将 (HUSA) 改为全身麻醉 (GA)。方法：我们进行了一项单中心、前瞻性、随机研究。HUSA组患者取手术髋部位于上方，低压麻醉溶液由9 mg罗哌卡因、5 µg舒芬太尼和1 mL无菌水组成。GA 组的麻醉进行了调整。每 3 分钟使用无创血压上臂袖带测量一次平均动脉压 (MAP)。低血压可通过推注麻黄碱治疗，然后连续静脉注射去甲肾上腺素，以获得 MAP ≥ 65 mm Hg。主要结局是严重低血压的发生，定义为 MAP <65 mm Hg 持续 > 12 分钟。结果：总共纳入 154 名患者。与 HUSA 组相比，GA 组严重低血压更常见（比值比，5.6；95% 置信区间，2.7–11.7；P < .001）。HUSA 组和 GA 组之间的短期结局没有显着差异：急性肾损伤（分别为 5.1% vs 11.3%；P = .22）、心肌损伤（18.0% vs 14.0%；P = .63）和 30 天死亡率（2.4% vs 4.7%；P = .65）。结论：与 GA 相比，在接受髋部骨折手术的老年人群中，HUSA 导致严重术中低血压的发生次数更少。