Why the study?
To compare the clinical efficacy of spinal anesthesia using bupivacaine combined with fentanyl versus bupivacaine alone in geriatric patients scheduled for total hip arthroplasty.
Does spinal anesthesia with bupivacaine plus fentanyl improve hemodynamic stability and prolong analgesia compared to bupivacaine alone in geriatric patients undergoing total hip arthroplasty?
Does spinal anesthesia with bupivacaine plus fentanyl improve hemodynamic stability and prolong analgesia compared to bupivacaine alone in geriatric patients undergoing total hip arthroplasty?
Adding fentanyl to a lower dose of bupivacaine for spinal anesthesia in elderly patients undergoing total hip arthroplasty improves hemodynamic stability and prolongs postoperative analgesia without increasing adverse effects.
May support lower-dose bupivacaine with fentanyl for better hemodynamics and analgesia in geriatric THA; hypothesis-generating, needs confirmatory trials.
OBJECTIVE: To determine and compare the clinical efficacy of spinal anesthesia with bupivacaine combined with fentanyl and bupivacaine alone in geriatric patients scheduled for total hip arthroplasty (THA). STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China, from April 2016 to April 2017. METHODOLOGY: Sixty-five geriatric patients were randomised into two groups. Group B was anesthetised with 0.5% bupivacaine 10 mg and Group F with 0.5% bupivacaine 7.5 mg plus fentanyl 20 μg. Hemodynamic stability, effect and satisfaction of anesthesia, time to the first postoperative analgesic requirement, adverse effects, and incidence of postoperative indwelling catheter were compared. RESULTS: There was no significant difference in time to reach maximum sensory block level, maximum sensory block level, maximum motor block, duration of motor block, quality of anesthesia, adverse effects or the incidence of postoperative indwelling catheter between the two groups. However, Group F required less dosage of ephedrine for stable hemodynamics and longer time to use the primary postoperative analgesic in comparison to Group B (p<0.05). CONCLUSION: Adding 20 μg fentanyl to a lower dose of 7.5 mg bupivacaine can provide safe and effective spinal anesthesia for THA in geriatric patients.
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Wang et al. (2019) studied this question.
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