Conscious sedation versus rapid sequence intubation for the reduction of native traumatic hip dislocation

Aravind K. Bommiasamy, Dayton Opel, Raluca McCallum, John D. Yonge, Vicente Undurraga Perl, Christopher R. Connelly, Darin Friess, Martin Schreiber, Richard Mullins

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Traumatic hip dislocations (THD) are a medical emergency. There is debate whether the painful reduction of a dislocated hip should be first attempted using primary conscious sedation (PCS) or primary general anesthesia (PGA) Methods: All cases of native THD from 2006 to 2015 in the trauma registry of a level 1 trauma center were reviewed. The primary outcome was successful reduction of the THD. Results: 67 patients had a native, meaning not a hip prosthesis, THD. 34 (50.7%) patients had successful PCS, 12 (17.9%) failed PCS and underwent reduction following PGA. 21 (31.3%) underwent PGA. Patients in the PGA group were more severely injured. Time to reduction greater than 6 h was associated with PCS failure (Odds ratio (95% confidence interval) 19.75 (2.06,189.10) p = 0.01). Conclusion: Clinicians treating patients with a THD can utilize either PCS or PGA with many patients safely reduced under PCS. However, patients whose hip have been dislocated for more than 6 h are at risk for failure with PCS, and are good candidates for PGA.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jan 1 2018

Keywords

  • Acute care
  • Anesthesia
  • Hip dislocation
  • Sedation
  • Trauma

ASJC Scopus subject areas

  • Surgery

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