[Continuous spinal anesthesia in very elderly patients with high anesthesia risk in traumatologic-orthopedic and general surgery interventions].
Continuous spinal anaesthesia (CSA) was carried out via a 28-gauge spinal catheter in 154 surgical patients at the Department of Anaesthesiology and Critical Care at Radeberg Asklepios-ASB Hospital between May 1992 and March 1999. The method was used preferably in patients aged over 70 (mean age 82.3 years) with high general risk during anaesthesia (ASA III-IV) who underwent orthopaedic or general surgery of the lower limb and hypogastrium. Remarkably, an anaesthetic level of between Th 8 and Th 10 was achieved with the low initial dose of 7.5 mg of 0.5% hyperbaric bupivacaine. Only minimal cardiovascular and respiratory side-effects were observed in comparison to single shot spinal and general anaesthesia. In the whole series, no anaesthesia-related complications were seen. Another benefit of CSA is the option of applying a second dose with longer duration of surgery to keep the optimal anaesthetic level. In addition, the method is suitable for postoperative analgesia over a period of 2 to 3 days.
Döhler
S
S
Abteilung für Anästhesie und Intensivmedizin, Asklepios-ASB-Klinik Radeberg.
Klippel
A
A
Richter
S
S
D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural; D000775:Anesthesia, Spinal; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D015207:Osteoarthritis, Hip / Q000601:surgery*; D018570:Risk Assessment