Impact of Regional Anesthesia on Blood Pressure in Humeral Fracture Surgery

Study Overview
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Brief Summary
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This study aims to compare the hemodynamic impact of two anaesthetic strategies : Regional anesthesia versus General anesthesia in proximal humeral fracture surgery.

Detailed Description
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Proximal humeral fracture surgery is frequently performed under General Anesthesia (GA). GA is frequently associated with a high risk of hypotension with significant consequences. Regional anesthesia could be an interesting alternative to GA in order to limit hemodynamic consequences, especially in elderly patients. Furthermore, in the current state of Covid 19 crisis, regional anesthesia could provide solutions in exposing less medical staff on patient's airway. The investigators hypothesize that the use of Regional anesthesia reduces the use of intraoperative vasopressor during surgery. After ethical committee approval, a retrospective cohort of patients with proximal humeral fracture, in Montpellier's University Hospital, was analyzed from 2016 to 2020. An informational note was given to all patients participating to the study.

Official Title
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Impact of Regional Anesthesia on Blood Pressure in Humeral Fracture Surgery : Comparative Study Using Propensity-score

Conditions
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Proximal Humeral Fracture

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA I - IV Proximal humeral fracture Operated between january 2016 and december 2020 Emergency surgery Exclusion Criteria: Surgical revision or surgery for pre-existing infection, tumour Intubated patient / unconscious patient Haemostasis disorder Haemostasis disorder Refusal of the patient

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants requiring vasopressors in peroperative | Number of Participants who used vasopressors in peroperative | during surgery (between anaesthethic induction and end of surgical procedure) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total dose of vasoconstrictor | Total dose of vasoconstrictor | during surgery (between anaesthethic induction and end of surgical procedure) | 
| Total time spent on vasopressor | Total time spent on vasopressor | during surgery (between anaesthethic induction and end of surgical procedure) | 
| Intraoperative complications | Intraoperative complications other than hypotension | during surgery (between anaesthethic induction and end of surgical procedure) | 
| Postoperative complications | nausea/vomiting; cardiovascular complications; complications related to regional anesthesia ; postoperative cognitive disorders | between surgery and 2 days post-operative | 
| total dose of rescue analgesia | opioids | between discharge from operating room and 24h post-operative | 
| Total time spent in the operating room | Total time spent in the operating room | between arrival in the operating room and discharge from the operating room | 
| Length of stay in duty or ICU | Length of stay in duty or ICU | between the day of surgery and up to 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Surgery, General Anesthesia, Regional anesthesia, Hypotension