[Continuous intradural anesthesia in geriatric patients undergoing orthopedic and traumatologic surgery].
OBJECTIVE
The aim of the study was to prospectively evaluate the results of continuous intradural anesthesia with 18G Tuohy needle and 20G catheter in geriatric patients.


METHODS
We studied 70 patients with a mean age of 75.9 +/- 10.8 years who were subjected to orthopedic or traumatologic surgery of the lower extremities with a duration of 104.6 +/- 53.6 min.


RESULTS
Success index was 95.7%. The initial dose of 1% tetracaine was 10.36 +/- 3.96 mg, the second dose in 29 patients was 7.2 +/- 2.7 mg, the third in 7 cases was 7.40 +/- 2.47 mg, and the total dose was 14.56 +/- 5.6 mg. The metameric level was between T8 and T11 in 80.32% of patients. Peroperative complications were limited to paresthesia in 5 cases (7.14%) during insertion of the catheter, difficulties in catheter placement in one case (1.42%), and accidental catheter extraction during withdrawal of the needle in 2 cases (2.85%). Ten patients (14.28%) presented arterial hypotension (pressure decrease greater than 30% of baseline systolic arterial pressure). During the postoperative phase there were 3 cases of slight headache after dural puncture (4.28%) that recovered with conservative treatment, and one case of lumbalgia at the puncture zone (1.42%).


CONCLUSIONS
Continuous intradural anesthesia with the material used in this study is technically easy. It allows to accurately reach the desired metameric level, avoiding massive sympathetic blockade, and providing a steady hemodynamic condition. All these effects are essential for anesthesia in geriatric patients.
de Andrés
J A
JA
Servicio de Anestesiología y Reanimación, Hospital General Universitario, Valencia.
Febré
E
E
Bolinches
R
R
Nalda
M A
MA
Fortuna
A
A
D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000295:instrumentation* / Q000379:methods; D002404:Catheterization / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D009985:Orthopedics; D011446:Prospective Studies; D014947:Wounds and Injuries / Q000601:surgery*
Anestesia intradural continua en pacientes geriátricos sometidos a cirugía ortopédica y traumatológica.