title: Hypotension in elderly patients undergoing spinal anaesthesia for repair of fractured neck of femur. A comparison of two different spinal solutions.
abstract: Intraoperative hypotension is a common and sometimes deleterious event in elderly patients undergoing spinal anaesthesia for repair of hip fractures. The synergism between intrathecal opioids and local anaesthetics may allow a reduction in the dose of local anaesthetic and reduce hypotension, while still maintaining adequate anaesthesia. We studied 42 elderly patients having insertion of a Richards pin and plate and compared 7.5 mg hyperbanic bupivacaine with added fentanyl 20 microg (group BF) to 12.5 mg hyperbaric bupivacaine alone (group B). Hypotension was defined as a fall in systolic blood pressure to less than 75% baseline or less than 90 mmHg and occurred with an overall incidence of 59.5%. There was no difference in the incidence or severity of hypotension between the two groups. Two patients from group B and one from group BF experienced mild discomfort. Pruritus was more common in group BF.
authors.affiliation: Department of Anaesthesia, Royal Perth Hospital, Western Australia.
authors.forename: J W
authors.initials: JW
authors.lastname: Martyr
authors.forename: M X
authors.initials: MX
authors.lastname: Clark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D002045:Bupivacaine; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005283:Fentanyl; D005593:Fracture Fixation, Internal; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000453:epidemiology*; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D011537:Pruritus / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine