To observe the safety and clinical efficacy of subarachnoid block anesthesia for hip surgery in elderly patients over 90 years of age.

From January 2014 to September 2015, 42 patients over 90 years old with hip fracture who underwent surgical treatment at the orthopaedics department of the Third People′s Hospital of Wuxi City were enrolled. All patients had ASA class Ⅱ or Ⅲ and underwent subarachnoid block anesthesia. The general information of the patients was collected, and intraoperative indicators were recorded. Invasive systolic blood pressure (ISBP), invasive diastolic blood pressure (IDBP), mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SpO₂) of patients when entering into the operating room (T₀), at 5 min (T₁), 10 min (T₂), 15 min (T₃), and 30 min (T₄) after the injection of anesthetics, and at the end of the surgery (T₅) were also recorded. One-way ANOVA was used for statistical analysis. The adverse reactions and the effect of anesthesia were also evaluated.

In the 42 cases, the mean dosage of bupivacaine was (11.20±1.45) mg, the mean operation time was (58.81±26.16) min, the mean blood loss was (114.39±63.05) mL, and the fluid replacement was (910.93±210.81) mL. There were 16 cases of vasopressor users, which accounted for 38.10% of all cases. Sensory block anesthesia was controlled at around the thoracic 10 level in all patients. No adverse reactions such as palpitation, chest tightness, dyspnea, chills, and nausea and vomiting occurred after injection. All the patients obtained excellent results. The ISBP, IDBP, and MAP at T₁-T₅ were significantly lower than those at T₀ (P<0.05). The HR at T₁-T₄ were significantly faster than that at T₀ (P<0.05). The SpO₂ was significantly higher at each time point after injection than at T₀ (P<0.01).

Subarachnoid block anesthesia is safe and effective in elderly patients (over 90 years old) undergoing hip surgery.