Low dose of isobaric bupivacaine provides lower incidence of spinal hypotension for hip surgery in elderly patients

  • Luiz Eduardo Imbelloni Doctor of Anesthesiology, Faculty of Medicine of Botucatu, Professor of Anesthesiology, School of Medicine, Nova Esperança, João Pessoa-PB Anesthesiologist Complexo Hospitalar Mangabeira, João Pessoa-PB
  • Rafaela Lopes Braga Nurse with specialization in the Intensive Care Unit, Nurse Surgical Center Complexo Hospitalar Mangabeira, João Pessoa-PB
  • Geraldo Borges de Morais Filho Master in Labour Economics, UFPB, João Pessoa-PB. Statistician of the Complexo Hospitalar Mangabeira, João Pessoa-PB
  • Alberto da Silva Technical nursing from the School of Nursing Santa Emilia de Rodat, Technical Nursing Center Surgical Complexo Hospitalar Mangabeira, João Pessoa-PB
Keywords: Hemodynamics, Regional anesthesia, Spinal anesthesia, Techniques

Abstract

Background and Objectives: Spinal anesthesia for surgical repair of hip fracture
in the elderly is associated with a high incidence of hypotension. The aim of this study was to compare the hemodynamic effects of a single injection of low dose (7.5 mg) versus full dose (15 mg) of isobaric bupivacaine.

Methodology: Fifty patients older than 60 years undergoing surgery for hip fracture were randomly divided into two groups of 25 patients. For spinal anesthesia, Group 1 received 15 mg of 0.5% isobaric bupivacaine and Group 2 received 7.5 mg of the same solution. Hypotension was defined as SBP decrease > 30% of the pressure in nursing and would be dealt with ethylephrine bolus of 2 mg.

Results: All patients showed satisfactory spinal anesthesia. With 15 mg four patients required one dose of ethylephrine and one patient required two doses to correct hypotension. In the group with 7.5 mg no patient developed hypotension. The lower dose reflected in significantly less cephalad spread, less motor block and shorter PACU stay.

Conclusion: The dose of 7.5 mg of isobaric bupivacaine for spinal anesthesia provides sufficient level of analgesia for surgical correction of hip fractures in elderly patients, eliminating the need for the use of vasopressor.

Citation: Imbelloni LE, Braga RL, Filho GBD, da Silva A. Low dose of isobaric bupivacaine provides lower incidence of spinal hypotension for hip surgery in elderly patients. Anaesth Pain & Intensive Care 2014;18(1):17-20

Published
07-02-2019
How to Cite
Imbelloni, L. E., Braga, R. L., Morais Filho, G. B. de, & da Silva, A. (2019). Low dose of isobaric bupivacaine provides lower incidence of spinal hypotension for hip surgery in elderly patients. Anaesthesia, Pain & Intensive Care, 17-20. https://doi.org/10.35975/apic.v0i0.548
Section
Original Articles