A Prospective Comparative Study of the Efficacy of Standard Dose Bupivacaine vs. Low Dose Bupivacaine with Fentanyl for Hip Arthroplasty in Elderly Females in a Tertiary Care Hospital in South India
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 5
Abstract
Neuraxial anaesthesia particularly spinal anaesthesia is the most popular form of anaesthesia for surgical repair of hip in the elderly because of its excellent operating conditions. But the associated high incidence of bradycardia and hypotension may be deleterious for them. Aims: To compare standard dose of bupivacaine with fentanyl vs. low dose bupivacaine with fentanyl for surgical repair of hip in elderly females with regard to its hemodynamic stability and adequacy for the procedure. Methods and Materials: After ethical committee approval and informed consent from patients a prospective observational study was performed on elderly females posted for elective or emergency surgical repair of hip fracture under spinal anaesthesia. This study was done among two comparable groups of ASA status I-IV and age 65 yrs and above. Low dose (Group A) received 1 ml of 0.5 % bupivacaine with25 µg fentanyl and Standard dose (Group B ) received 2 ml of 0.5% bupivacaine with 25 µg fentanyl. Statistical software: MS Excel, SPSS version 22 (IBM SPSS Statistics, Somers NY, USA) was used to analyze data. Results: Low dose spinal provides adequate duration of analgesia. Significant difference in mean blood pressure (BP) between 2 groups (P=0.001).Dose of vasopressors required to maintain BPin low dose ( vs. (13.6 ± 7.4 mg)in standard dose group. Onset of sensory block delayed in low dose group. Conclusions: This study shows that low dose spinal anaesthesia provides adequate anaesthesia for surgical repair of hip fracture in elderly females with excellent hemodynamic stability.
Authors and Affiliations
Dr Biby Mary Kuriakose
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