ICAA WACA Anesthesia for Geriatric Hip Surgery - Precise Individualization Real or Dream?

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This case Discuss a 90-year-old man with atrial fibrillation undergoing hip surgery.
Summarize several key questions in this discussion.
1.
How do you evaluate patients with atrial fibrillation before surgery? What preparations and inspections do you need to do? If this patient has a fresh thrombus in the left atrial appendage, how do you balance the risk of orthopaedic surgery and thrombus shedding? 2.
Will you read the coagulation report? What is the specific meaning of each value? What do these changes mean? 3.
The anesthesia management of super-elderly patients, from preoperative assessment to induction to maintenance to extubation to postoperative management, should be well-understood.
Detailed preoperative preparations and plans should be made.
For details of anesthesia management in elderly patients, please refer to the consensus guideline to the public.
Article 4.
What was the cause of the refractory hypotension at the time of induction in this patient? How to prevent it from happening in the future? How should anesthesia dose be selected? How to choose vasoactive drugs? 5.
What is the preferred method of anesthesia for hip fractures? For how to administer the speed and dosage, please refer to the expert consensus on hip fracture.
The article before the official account has an easter egg: Ultrasound Little Prince Zhao Daqiang interprets the hip nerve 1.
Skin: the gluteal epithelial nerve, the lateral cutaneous branch of the subcostal nerve, the ilium hypogastric Lateral cutaneous branch of nerve and lateral femoral cutaneous nerve 2.
Muscle: lumbar plexus and sacral plexus 3.
Joint capsule: 3.
1.
Anterior femoral nerve + obturator nerve 3.
2.
Acetabular labial obturator nerve articular branch + accessory obturator nerve 3.
3.
The articular muscle branch of the posterior quadratus femoris branch + the superior gluteal nerve + the articular branch of the sciatic nerve The most important is the femoral nerve + obturator nerve 4.
Bone: nerve branches of the lumbar plexus and sacral plexus