Hemodynamic impact of isobaric levobupivacaine versus hyperbaric bupivacaine for subarachnoid anesthesia in patients aged 65 and older undergoing hip surgery

The altered hemodynamics, and therefore the arterial hypotension is the most prevalent adverse effect after subarachnoid anesthesia. The objective of the study was to determine the exact role of local anesthetic selection underlying spinal anesthesia-induced hypotension in the elderly patient. We co...

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Bibliographic Details
Published in:BMC anesthesiology 2014-10, Vol.14 (1), p.97-97, Article 97
Main Authors: Herrera, Rosa, De Andrés, Jose, Estañ, Luis, Olivas, Francisco J Morales, Martínez-Mir, Inocencia, Steinfeldt, Thorsten
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anesthesia
Anesthesia, Local - methods
Anesthesiology
Anesthetics, Local - adverse effects
Atmospheric Pressure
Blood pressure
Bone surgery
Bupivacaine - adverse effects
Bupivacaine - analogs & derivatives
Drug dosages
Female
Fractures
Heart attacks
Hemodynamics - drug effects
Hip Fractures - surgery
Hip joint
Humans
Hypotension - chemically induced
Male
Middle Aged
Mortality
Older people
Orthopedic Procedures - methods
Pilot Projects
Respiratory Mechanics - drug effects
Studies
Subarachnoid Space
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Summary:The altered hemodynamics, and therefore the arterial hypotension is the most prevalent adverse effect after subarachnoid anesthesia. The objective of the study was to determine the exact role of local anesthetic selection underlying spinal anesthesia-induced hypotension in the elderly patient. We conducted a descriptive, observational pilot study to assess the hemodynamic impact of subarachnoid anesthesia with isobaric levobupivacaine versus hyperbaric bupivacaine for hip fracture surgery. Hundred twenty ASA status I-IV patients aged 65 and older undergoing hip fracture surgery were enrolled. The primary objective of our study was to compare hemodynamic effects based on systolic blood pressure (SBP) and dyastolic blood pressure (DBP) values, heart rate (HR) and hemoglobin (Hb) and respiratory effects based on partial oxygen saturation (SpO2%) values. The secondary objective was to assess potential adverse events with the use of levobupivacaine versus bupivacaine. Assessments were performed preoperatively, at 30 minutes into surgery, at the end of anesthesia and at 48 hours and 6 months after surgery. Among intraoperative events, the incidence of hypotension was statistically significantly higher (p
ISSN:1471-2253
1471-2253
DOI:10.1186/1471-2253-14-97