Geriatric Anesthesia: Podcast with Mark Neuman, Liz Whitlock, and Cindy Hsu
Geriatric anesthesia is a thing.\xa0 The average age of people getting surgery is increasing.\xa0 Anesthesiologists and surgeons feel that with new techniques and approaches they can perform surgery on patients at ever older ages, patients who they previously would have excluded from surgery.\xa0\xa0
One of the key advances in geriatric anesthesia is the use of spinal anesthesia, a form of regional anesthesia that also includes epidurals and peripheral nerve blocks.\xa0 When older adults experience a hip fracture, there\u2019s a growing consensus that spinal anesthesia offers superior outcomes compared to general anesthesia.\xa0\xa0
It\u2019s surprising therefore, to talk with Mark Neuman about the results of his randomized trial in NEJM, which finds essentially no difference between general anesthesia and spinal. Importantly, as a primary outcome Mark selected walking ability based on feedback from older adults - this is the outcome our patients care about most.\xa0 But he finds no difference in primary outcome or secondary outcomes, including (surprisingly) delirium.\xa0\xa0
We break down potential reasons, with thoughtful commentary from Liz Whitlock and Cindy Hsu, two anesthesiologists with experience caring for older adults with hip fracture.\xa0 Liz is a friend of the pod and researcher who we interviewed previously about \u201cpumphead.\u201d\xa0 Cindy is...my wife.\xa0 She also helps me out with the accompaniment on piano as it\u2019s tough for me to play guitar with a broken clavicle.\xa0 Thank you dear wife!\xa0 We had fun learning to play/sing Drivers License by Olivia Rodrigo.\xa0 Ah...teen angst...the angst!!!
-@AlexSmithMD