[Selective subarachnoid anesthesia for intervention for hip fracture].
METHODS
50 ASA I-IV patients (62-90 aged, mean 78.54 +/- 6.48) were submitted to subarachnoidal selective anaesthesia with hyperbaric 1% bupivacaine and morphine for hip surgery. The aim of the study was to evaluate the clinical effectiveness of this anaesthetic technique. Ketamine 0.25 mg/kg and propofol 0.5 mg/kg were administered intravenously before positioning the patients homolaterally to the sick hip. The subarachnoidal puncture was effected at L2-L3 or L3-L4 level with a 22 gauge Quinke or Whitacre needle. The mean dose of bupivacaine was 7.72 +/- 0.81 mg and the mean dose of morphine was 0.23 +/- 0.03 mg. No patient needed general anaesthesia; 3 patients needed small boluses of ketamine and propofol or fentanyl (50 gamma) before the end of surgery. Ephedrine (5 mg) was administered to 5 patients to counteract hypotension by sympathetic block. Only one patient needed extra analgesia up to 8 hours after surgery (Ketorolac 60 mg).


RESULTS
The morphine side effects were 3 cases of itch (6%), 4 cases of drowsiness (8%), 5 cases of nausea and vomiting (10%), 1 case of herpes labialis (2%); the subarachnoidal puncture caused one case of headache.


CONCLUSIONS
The authors believe that such an easily executable anaesthetic technique is safe enough even in elderly patients.
Porcelli
P
P
Servizio di Anestesia e Rianimazione, A.U.S.L. Bari 1, Presidio Ospedaliero di Corato, Bari.
Di Gioia
M
M
Lorusso
V M
VM
Barbone
G
G
D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000379:methods*; D004809:Ephedrine; D005260:Female; D005283:Fentanyl; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007649:Ketamine; D008297:Male; D008875:Middle Aged; D011229:Preanesthetic Medication; D015742:Propofol; D013346:Subarachnoid Space
D007649:Ketamine; D004809:Ephedrine; D005283:Fentanyl; D015742:Propofol
Anestesia subaracnoidea selettiva per interventi di frattura di anca.