Anesthesia, Spinal
Conditions
Keywords
hemodynamic management, spinal anesthesia, geriatric anesthesia
Brief summary
In this study, it was planned to provide more stable hemodynamics in geriatric patients with low-dose spinal anesthesia. We will compare 7.5mg hyperbaric bupivacaine with 5mg hyperbaric bupivacaine. The researchers hypothesized that low-dose bupivacaine would provide adequate anesthesia, less hypotension, and faster recovery.
Detailed description
Hypothesis It is hypothesized that low-dose bupivacaine can provide adequate anesthesia, less hypotension, and faster recovery. patient population Patients over 65 years of age who will undergo spinal anesthesia due to hip fracture. Hemodynamic data(Blood pressure-mmHg, heart rate-beats per minute) of patients, bromage scores, perfusion index (PI) values, discharge time, pain with NRS (numerical rating scale), patient satisfaction will be evaluated ( Numeric output from 1-10). Hemodynamic variables will be recorded every 2 minutes in the first 20 minutes after spinal anesthesia. hemodynamic variables will be recorded 30 minutes after spinal anesthesia and at the end of the operation. The perfusion index is the ratio of the blood volume to the pulsatile to non-pulsatile fraction. An increase in the pulsatile fraction that occurs during vasodilation corresponds to a higher PI. Therefore, patients with a higher PI have a higher risk of post-spinal hypotension.
Interventions
OTHER7.5 mg hyperbaric bupivacaine
Spinal anesthesia with 7.5 mg hyperbaric bupivacaine after preoperative peng (pericapsular nerve group) block
OTHER5 mg hyperbaric bupivacaine
Spinal anesthesia with 5 mg hyperbaric bupivacaine after preoperative peng (pericapsular nerve group) block
Sponsors
Ankara City Hospital Bilkent
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* ASA(American Society of Anesthesiologists) I-II-III patients * BMI( body mass index) in the range of 18-40 * over 65 years old hip fracture
Exclusion criteria
* Refusal to participate in the study * Left ventricular ejection fraction below 40% * cardiac arrhythmia * Patients with peripheral vascular disease * Failure of spinal anesthesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| hemodynamic variability | every 2 minutes for the first 20 minutes after spinal anesthesia | intraoperative hemodynamic variables (BP(blood pressure-mmHg) during hip surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sensory Levels | 24 hours | Sensory levels will be measured every 30 minutes until discharge from PACU(post-anaesthesia care unit) |
| ephedrine use | 24 hours | ephedrine consumption , mg in hip surgery |
| perfusion index variability | every 2 minutes for the first 20 minutes after spinal anesthesia | To correlate between perfusion index and hypotension after spinal anaesthesia in hip surgery |
| bromage scale | 24 hours | Bromage Scores every 30 minutes until discharge from PACU(post-anaesthesia care unit). |
| NRS(numerical rating scale) | 2 hours | pain scoring a score of 1 to 10 |
| fentanyl use | 24 hours | fentanyl consumption , mcg in hip surgery |
Countries
Turkey (Türkiye)
Outcome results
None listed