# Leg compression for preventing hypotension after spinal anesthesia in elderly hip fracture patients

## TL;DR

This study found that using compression stockings on the uninjured leg may help reduce hypotension in elderly patients after hip fracture surgery.

## Contribution

The study evaluates the use of compression stockings for preventing hypotension in elderly hip fracture patients, a novel application outside of obstetric surgery.

## Key findings

- Compression stockings significantly reduced concomitant intraoperative and postoperative hypotension.
- There was a non-significant reduction in postoperative hypotension and hypotension-related complications.
- Baseline characteristics and intraoperative vasopressor use were similar between groups.

## Abstract

Hip fracture (HF) is a common geriatric trauma resulting in a substantial rate of mortality and morbidity. Previous studies have shown that the application of leg compression significantly reduced the incidence of perioperative hypotension (PeH) and hypotension-related complication in obstetric surgery. The objective of this study was to evaluate the effect of medical compression stocking for prevention of PeH in elderly patients undergoing HF surgery.

Sixty patients were randomized in 2 groups: compression stocking (CS) group and no compression stocking (NCS) group (n = 30 each). Compression stockings were worn on the uninjured leg after spinal anesthesia and then removed after 24 h postoperatively. Demographic and perioperative data were collected. Primary outcome was the incidence of PeH measuring as 3 methods: intraoperative hypotension (IoH), postoperative hypotension (PoH), and concomitant intraoperative and postoperative hypotension (CoIPH). The secondary outcomes were the incidence of using intraoperative vasopressor and in-hospital hypotension-related complications related to hip fracture.

Baseline characteristics such as age, gender, diagnosis and operation were not significant difference between groups (p > 0.05 all). Regards the PeH, CS group demonstrated a significantly lower incidence in CoIPH than NCS group (0 patients vs. 6 patients, p = 0.02), and also showed a non-significantly lower incidence of the PoH and hypotension-related complication (p = 0.13 and 0.10, respectively). However, the IoH, and the need of intraoperative vasopressor did not significantly differ between both groups (p > 0.05 all).

The application of medical compression stocking in elderly patients undergoing HF surgery demonstrated an ability to reduce the incidence of hypotension perioperatively and might prevent in-hospital hypotension-related complication.