Comparison between two Different Doses of Hyperbaric Bupivacaine in Unilateral Spinal Anesthesia among Geriatric Patients in Hemiarthroplasty Surgery

Abstract

Background: The advantage of unilateral spinal anaesthesia is that it provides a stronger block on the side of surgery, accelerated recovery of the nerve block with better maintenance of cardiovascular stability. Hence it could be a suitable technique for high risk geriatric patients. Objective: To compare two different doses of hyperbaric bupivacaine in unilateral spinal anaesthesia among geriatric patients in hemiarthroplasty surgery. Methods: This randomized controlled clinical trial was conducted in the Department of Anaesthesia and Intensive Care Medicine, National Institute of Traumatology and Orthopaedics Rehabilitation (NITOR), Dhaka, Bangladesh. Total 60 geriatric patients who underwent hemiarthroplasty surgery were enrolled and divided into two groups (30 patients in each group). Group A was received 10 mg hyperbaric bupivacaine plus 20 µg fentanyl and Group B was received 7.50 mg hyperbaric bupivacaine plus 20 µg fentanyl. The time onset of sensory and motor block, level of sensory and degree of motor block and the duration of sensory and motor block were assessed accordingly. Results: No significant difference was found in duration of surgery, onset of sensory and motor block on operative limb between the groups (p >0.05). The haemodynamic parameters were well maintained in group B. The time for 1st demand of analgesia, time of complete sensory and motor recovery was significantly earlier in group B (p <0.05). The higher dose had developed comparatively high peri-operative complications. Conclusion: Unilateral spinal block with a low dose of local anesthetic is safe and effective method for hemiarthroplasty surgery in geriatric patients