Fractional Spinal Anesthesia and Systemic Hemodynamics in Frail Elderly Hip Fracture Patients.
Status:
Completed
Trial end date:
2021-02-16
Target enrollment:
Participant gender:
Summary
Aging and frailty make the elderly patients susceptible to hypotension following spinal
anaesthesia. The systemic haemodynamic effects of spinal anaesthesia are not well known. In
this study, we examine the systemic haemodynamic effects of fractional spinal anaesthesia
following intermittent microdosing of a local anesthetic and an opioid.
We included 15 patients aged over 65 with considerable comorbidities, planned for emergency
hip fracture repair. Patients received a spinal catheter and cardiac output monitoring using
the LiDCOplus system. Invasive mean arterial pressure (MAP), cardiac index, systemic vascular
resistance index, heart rate and stroke volume index were registered. Two doses of
bupivacaine 2,25 mg and fentanyl 15µg were administered with 25 minutes in between.
Hypotension was defined as a fall in MAP by >30% or a MAP <65 mmHg