Key result
Continuous spinal anesthesia resulted in fewer postoperative cardiovascular (38.5% vs 60.0%) and respiratory (0% vs 30.0%) complications compared to general anesthesia in elderly patients undergoing emergency abdominal surgery.
Why the study?
Does continuous spinal anesthesia reduce postoperative complications compared to general anesthesia in elderly patients over 80 years old undergoing emergency abdominal surgery for ileus?
Observational (n=23)
No
Does continuous spinal anesthesia reduce postoperative complications compared to general anesthesia in elderly patients over 80 years old undergoing emergency abdominal surgery for ileus?
Continuous spinal anesthesia may be superior to general anesthesia in elderly patients undergoing emergency abdominal surgery due to a lower incidence of postoperative pulmonary and cardiovascular complications.
Answers are grounded in this paper and cite their sources.
Continuous spinal anesthesia was associated with fewer complications in elderly emergency surgery; leaves open need for RCTs before practice change.
Two anesthetic methods, general anesthesia (GA) and continuous spinal anesthesia (CSA), were compared for postoperative complications in emergency surgery for aged patients with ileus. Subjects were 23 aged patients over 80 years old, and 10 to them underwent GA and the remaining 13, CSA. There were no significant differences in their age, operation time, and intraoperative water-balance between both groups. The most common postoperative complications was cardiovascular disease which occurred in 60.0% and 38.5% in GA and CSA group respectively, followed by respiratory disease which occurred in 30.0% and 0%, respectively. PaO2 value on 2nd postoperative day in GA group was significantly lower than that in CSA group. In GA group, GOT and GPT values tended to increase postoperatively, but not in CSA group. It is thought that CSA is a superior method of anesthesia to GA in emergency abdominal surgery for aged patients, because it has fewer effects on the homeostasis of the body and a lower incidence of postoperative pulmonary complications.
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Takahara et al. (1994) conducted an observational in Ileus requiring emergency abdominal surgery (n=23). Continuous spinal anesthesia (CSA) vs. General anesthesia (GA) was evaluated on Postoperative cardiovascular complications. Continuous spinal anesthesia resulted in fewer postoperative cardiovascular (38.5% vs 60.0%) and respiratory (0% vs 30.0%) complications compared to general anesthesia in elderly patients undergoing emergency abdominal surgery.
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