ArticleFrontiers in neurology
S-ketamine plus dexmedetomidine vs. S-ketamine plus propofol for sedation-analgesia during positioning for spinal anesthesia in older adults undergoing lower extremity fracture surgery.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Positioning for neuraxial anesthesia in geriatric lower extremity fracture surgery is painful and can destabilize hemodynamics. Sedation-analgesia must balance effective analgesia with respiratory safety and physiologic stability. Methods: This single-center retrospective cohort study included patients aged ≥65 years undergoing lower extremity fracture surgery under spinal anesthesia who received S-ketamine plus dexmedetomidine (Group A, Results: A total of 100 records were screened, and 94 patients were analyzed. Group×stage interactions were significant for pain and posture quality. Group A had lower pain during the most noxious stages (T3-T5; adjusted differences -0.42 to -0.50) and higher odds of better posture quality (OR 2.30-2.70). Physiological differences were modest and stage-specific, with slightly higher SpO Conclusion: In this retrospective cohort, dexmedetomidine-based sedation with S-ketamine was associated with improved comfort and cooperation during spinal positioning compared with propofol-based sedation, while adverse events were infrequent in both groups.
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