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January 1, 2018Tanta Medical Journal

Single-shot spinal anesthesia with heavy bupivacaine in two regimens versus continuous spinal anesthesia in elderly patients undergoing hip surgery: a prospective randomized controlled study

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Why the study?

Does continuous spinal anesthesia improve hemodynamic stability and block characteristics compared to single-shot spinal anesthesia with heavy bupivacaine in elderly patients undergoing hip surgery?

Population

60 patients aged 65 years or older scheduled for hip surgery

Comparison

Single-shot spinal anesthesia with hyperbaric… vs Continuous spinal anesthesia (Group C)

Design

RCT, Randomized into three groups (n=20)

Follow-up

6 hours postoperatively

Authors

AKAliaaM.A.R Abdel KaderTanta UniversityKHKamalE Ali HekalTanta UniversityYRYaserM Amr RaghebTanta University

Discussion

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Implication

Supports continuous spinal anesthesia in elderly hip surgery; extends RCT evidence on stability and dosing.

Structured PICO

Does continuous spinal anesthesia improve hemodynamic stability and block characteristics compared to single-shot spinal anesthesia with heavy bupivacaine in elderly patients undergoing hip surgery?

P
Population
60 patients aged 65 years or older scheduled for hip surgery
I
Intervention
Single-shot spinal anesthesia with hyperbaric bupivacaine 7.5 mg (Group A) or hyperbaric bupivacaine 5 mg + 25 μg fentanyl (Group B)
C
Comparator
Continuous spinal anesthesia (Group C)
O
Outcome
Heart rate, mean arterial pressure, onset, duration, and level of sensory block, and onset, duration, and score of motor blocksurrogate

Continuous spinal anesthesia provides better hemodynamic stability and requires lower doses of local anesthetics compared to single-shot spinal anesthesia in elderly patients undergoing hip surgery.

Cite This Study

Kader et al. (2018) studied this question.

synapsesocial.com/papers/6a8333ded1e5557f1151b781https://doi.org/10.4103/tmj.tmj_30_17
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Low‐dose bupivacaine with sufentanil prevents hypotension after spinal anesthesia for hip repair in elderly patients2004 · 98 citations
  2. 2Minidose Bupivacaine–Fentanyl Spinal Anesthesia for Surgical Repair of Hip Fracture in the Aged2000 · 200 citations
  3. 3Fast-Track Eligibility of Geriatric Patients Undergoing Short Urologic Surgery Procedures2002 · 58 citations
  4. 4Comparative Effectiveness of Regional Versus General Anesthesia for Hip Fracture Surgery in Adults2013 · 74 citations
  5. 5Incidence and Mortality of Hip Fractures in the United States2010 · 8 citations