The Role of Precision Anesthesia Strategy on Perioperative Organ Protection in Hip Surgery [PASPOP]

Summary

The goal of this clinical trial is to investigate the effect of three anesthetic strategies on organ protection in elderly patients undergoing hip fracture surgery.

The main questions it aims to answer are: 1.Does the nerve block anesthesia group have a protective effect on the incidence of postoperative delirium in elderly patients undergoing hip surgery? 2.Does the nerve block anesthesia group also provide protective effects on other organs for elderly patients undergoing hip surgery? 3.What effects will these anesthetic strategies have on short-term and long-term prognosis of elderly patients undergoing hip surgery?

The investigators will compare it with the spinal anesthesia group and the general anesthesia group to see which has a better protective effect on organs.

Participants will undergo preoperative interviews and will be interviewed twice daily, in the morning and evening, from postoperative day 1 to 7 or until discharge, to assess the occurrence of delirium and cognitive levels, pain intensity, and sleep status.

Interventions:

1. Nerve block anesthesia group (NA group): Combined Lumbar and Sacral Plexus Block + sedation or laryngeal mask anesthesia
2. General anesthesia group (GA group): General anesthesia (Endotracheal intubation) + iliac fascial block
3. Spinal anesthesia group (SA group): Spinal anesthesia without any nerve blockade

Conditions

• Elderly (People Aged 65 or More)
• Hip Fracture
• Delirium - Postoperative
• Organ Protection
• Nerve Block

Interventions

PROCEDURE

Combined Lumbar Plexus and Sacral Plexus Block

This intervention of Combined Lumbar Plexus and Sacral Plexus Block is assigned to Nerve block anesthesia group (NA group): A combined Lumbar Plexus Block (0.33% Ropivacaine 30ml) and Sacral Plexus Block (0.33% Ropivacaine 20ml) administered as a single injection.

PROCEDURE

iliac fascial block

iliac fascial block administered as a single injection below the iliac fascial with 0.33% ropivacaine 30ml.

PROCEDURE

spinal anesthesia

Spinal anesthesia was performed as a standard care of spinal anesthetic. The spinal puncture site is at L2-3 or L3-4. After the puncture needle reaches the subarachnoid space, 1% ropivacaine 0.8-2 ml, totaling 8-20mg, is injected. Depending on the center's practice, it may be replaced with an equivalent dose of bupivacaine .

Sponsors & Collaborators

• Army Medical Center of PLA

  collaborator OTHER_GOV

• Shanghai Jiao Tong University Affiliated Sixth People's Hospital

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-12-01

Primary Completion

2025-03-12

Completion

2025-04-05

Countries

• China

Study Locations