More likelihood of Acute Kidney Injury during Hip Stabilization Surgery under GA

According to a study presented at the 2011 annual spring meeting of the American Society of Regional Anesthesia and Pain Medicine, the chances of developing acute kidney injury (AKI) in patients undergoing hip stabilization surgery are much higher when the surgery is performed under general anesthesia compared to when it is performed under regional anesthesia. The research was conducted by the researchers from University of Florida College of Medicine, Gainesville.

The researchers made this observation on the basis of a retrospective cohort study which included 308 patients. All the patients were above the age of 65 and were operated for low impact hip fracture between 2006 and 2008. 73 patients underwent the procedure under regional anesthesia while 235 were operated under general anesthesia. The regional anesthesia was administered as neuraxial anesthesia through continuous intrathecal catheters. The patients were placed under conscious sedation. Intrathecal catheters were preferred over spinal anesthesia considering the old age of the patients and to minimize hemodynamic changes associated with it. Epidural anesthesia was avoided in order to achieve complete muscle relaxation. The patients who received general anesthesia were either given inhalation anesthetics or anesthetic agents were administered through intravenous route.

The creatinine levels of the patients were measured at the time of admission and at the time of discharge. The researches noticed that none of the 73 patients who received regional anesthesia, developed renal failure or required renal replacement therapy. 2% of the patients who were operated under general anesthesia landed up with renal failure and almost 3% required renal replacement therapy. 11% of patients receiving general anesthesia required hospitalization in the intensive care unit in the post-operative period compared to just 4% in case of regional anesthesia. 4% of general anesthesia patients also required transfusion compared to none who received regional anesthesia.

Thus, the researchers concluded that regional anesthesia is associated with less chances of developing acute kidney injury after undergoing hip stabilization surgery. As patients with acute kidney injury have a higher incidence of post-operative complications, regional anesthesia should be preferred in such cases.


Wednesday, February 1, 2012