Orthogeriatric Anaesthesia

Abstract

The relationship between an orthogeriatrician and anaesthetist is fundamental to the continuous provision of medical care from hospital admission through to hospital discharge after hip fracture. Three phases of care define this relationship—preoperative preparation, intraoperative normalisation of physiology and postoperative re-enablement. Preoperatively, the aim should be to normalise any medical conditions so that surgery is not delayed. Intraoperatively, the anaesthetist should aim to deliver standardised anaesthesia that returns the patient to orthogeriatric care postoperatively pain-free and ready for remobilisation and re-enablement; postoperative care is a continuation of this process. Both anaesthetists and orthogeriatricians need to engage in continuous quality improvement programmes that aim to reduce hospital and national variations in perioperative care provision for this vulnerable group of patients.