Juliana Josphine, J (2014) A Randomised Control study comparing the efficacy of 0.25% Isobaric Bupivacaine to 0.5% Hyperbaric Bupivacaine during Spinal Anesthesia for Hip Surgeries in people aged 60 Years and Above. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION: The incidence of accidental falls seems to increase with an increase in age. This results in people of the elderly age group landing up with serious injuries like long bone fractures that require surgical intervention. Providing anesthesia to this age group can prove to be quite a challenge as a senior citizen usually presents with a number of co morbidities like hypertension, diabetes, ischemic heart disease and so on. Though regional anesthesia is advantageous in them, it becomes crucial for the anesthetist to maintain the hemodynamics intraoperatively. The chances of spinal hypotension can probably be lowered by reducing the baricity of the local anesthetic agent. Hence our goal was to see if isobaric bupivacaine provided a more stable intra operative period compared to hyperbaric bupivacaine and we also compared the adequacy of sensory and motor blockade provided by them during surgery. METHODS: After getting the approval of the institutional review board and estimating the sample size using Van Gessel’s study, 31 patients were randomly allocated to two different groups by a computer generated sequence. The control group received 3ml (15mg) of 0.5% hyperbaric bupivacaine and the study group received 6ml (15mg) of 0.25% isobaric bupivacaine without any additives. All patients received the spinal anesthesia in the sitting position and were made supine almost immediately. Their blood pressure, heart rate and level of sensory and motor blockade were monitored intraoperatively and in the recovery room. RESULTS: The incidence of hypotension and the need for ionotropic support was much lesser with 0.25% isobaric bupivacaine and it was statistically significant with a p value of 0.002 and 0.005 respectively. The time of onset, maximal cephalad spread and adequacy of motor and sensory blockade were similar with both groups. The overall complication rate was also much higher with the hyperbaric group with a significant p value of 0.001. CONCLUSION: 0.25% isobaric bupivacaine provides a stable intraoperative hemodynamic condition compared to hyperbaric bupivacaine in the elderly population.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.201220355 |
| Uncontrolled Keywords: | Spinal anesthesia, hyperbaric Bupivacaine, isobaric Bupivacaine, hemodynamic stability. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Subramani R |
| Date Deposited: | 09 Jul 2020 05:42 |
| Last Modified: | 09 Jul 2020 05:44 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12509 |
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