[Anesthetic support of operations on the hip joint in senile patients].

ABSTRACT

The impact of spinal anesthesia on a surgical stress response during prosthetic repair of the hip joint was studied in 56 senile patients (mean age 76 +/- 2.1 years). Hemodynamic changes, the time course of fluid distribution in different sectors, the activities of sympathoadrenal, cholinergic, serotoninergic, and histaminergic systems were analyzed. Studies were conducted in 4 steps: before a planned operation, before anesthesia, after the end of surgery, and 24 hours after intervention. The characteristic features of hemodynamic changes were elevated left ventricular filling pressure and high specific peripheral resistance, which was regarded as signs of latent heart failure and age-related vascular tone regulatory changes. Involutional tissue processes in senile patients appeared as decreased water levels in the cellular sector. The patients' sympathoadrenal and enterochromaffin systems were in a state of hypofunction. The adequacy of anesthesia supports no trend in the study neurohumoral regulatory parameters. The low level of hormones and mediators confirms the true depletion of the neurohumoral regulatory system.