Why the study?
Does adding fentanyl to a reduced dose of hyperbaric bupivacaine reduce hypotension compared to standard dose hyperbaric bupivacaine in elderly patients undergoing spinal anaesthesia for hip fracture repair?
Does adding fentanyl to a reduced dose of hyperbaric bupivacaine reduce hypotension compared to standard dose hyperbaric bupivacaine in elderly patients undergoing spinal anaesthesia for hip fracture repair?
Adding fentanyl to a reduced dose of bupivacaine does not reduce the incidence or severity of intraoperative hypotension in elderly patients undergoing spinal anesthesia for hip fracture repair.
Intraoperative hypotension is a common and sometimes deleterious event in elderly patients undergoing spinal anaesthesia for repair of hip fractures. The synergism between intrathecal opioids and local anaesthetics may allow a reduction in the dose of local anaesthetic and reduce hypotension, while still maintaining adequate anaesthesia. We studied 42 elderly patients having insertion of a Richards pin and plate and compared 7.5 mg hyperbanic bupivacaine with added fentanyl 20 microg (group BF) to 12.5 mg hyperbaric bupivacaine alone (group B). Hypotension was defined as a fall in systolic blood pressure to less than 75% baseline or less than 90 mmHg and occurred with an overall incidence of 59.5%. There was no difference in the incidence or severity of hypotension between the two groups. Two patients from group B and one from group BF experienced mild discomfort. Pruritus was more common in group BF.
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Martyr et al. (2001) studied this question.
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