Spinal anesthesia using single injection small-dose bupivacaine versus continuous catheter injection techniques for surgical repair of hip fracture in elderly patients

Anesthesia and Analgesia
Vincent MinvilleKamran Samii

Abstract

Aging and disease may make elderly patients particularly susceptible to hypotension during spinal anesthesia. We compared the hemodynamic effect of continuous spinal anesthesia (CSA) and small dose single injection spinal anesthesia (SA) regarding the incidence of hypotension. Seventy-four patients aged >75 yr undergoing surgical repair of hip fracture were randomized into 2 groups of 37 patients each. Group CSA received a continuous spinal anesthetic with a titration of 2.5 mg boluses every 15 min of isobaric bupivacaine, while group SA received a single injection spinal anesthetic with 7.5 mg of isobaric bupivacaine. The overall variations in noninvasive automated arterial blood pressure were not statistically significantly different in the 2 groups at baseline and after CSA or SA (not significant). In the SA group, 68% of patients experienced at least one episode of hypotension (decrease in systolic arterial blood pressure greater than 20% of baseline value) versus 31% of patients in the CSA group (P = 0.005). In the SA group, 51% of patients experienced at least one episode of severe hypotension (decrease in systolic arterial blood pressure more than 30% of baseline value) versus 8% of patients in the CSA group (P < 0.0001)...Continue Reading

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Citations

Dec 5, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Vincent MinvilleOlivier Fourcade
Nov 26, 2010·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·T J LugerJ Kreutziger
Jun 24, 2009·American Journal of Therapeutics·James M Moore
Jun 19, 2012·Journal of Neurosurgery. Pediatrics·Alexis J JoannidesRikin A Trivedi
May 3, 2011·Annales Françaises D'anesthèsie Et De Rèanimation·V ChhorT Lescot
Aug 29, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·L LonjaretV Minville
May 1, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·J TurcJ-Y Martinez
Sep 29, 2011·Annales Françaises D'anesthèsie Et De Rèanimation·F Ferré, V Minville
Sep 22, 2015·Anaesthesia Critical Care & Pain Medicine·Olivier LairezVincent Minville
Jun 8, 2012·Anaesthesia·L LonjaretV Minville
Nov 29, 2007·Anesthesia and Analgesia·Anna RabinowitzOlivier Fourcade
Mar 21, 2009·Anesthesia and Analgesia·Vincent MinvilleOlivier Fourcade
Jun 26, 2020·Local and Regional Anesthesia·Fabrice FerréVincent Minville
Oct 23, 2019·Korean journal of anesthesiology·Byung-Gun Lim, Il-Ok Lee
May 7, 2021·Case Reports in Anesthesiology·Sharad Khakurel, Rupesh Kumar Yadav

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