Haemodynamic effects of intrathecal bupivacaine for surgical repair of hip fracture.
OBJECTIVE
To determine the optimal dose of bupivacaine in providing adequate surgical anaesthesia with minimal haemodynamic disturbances.


METHODS
Three different doses of spinal bupivacaine in combination with or without fentanyl for surgical repair of hip fracture were used. Sixty patients were randomly divided into three groups (A, B and C) to receive a spinal anaesthetic of bupivacaine 10mg, 8mg and 6mg respectively. In addition to bupivacaine, group B and C also received fentanyl 20 microg in spinal mixture.


RESULTS
Intra operative heart rate was statistically insignificant in all three groups. Statistically significant drop in systolic blood pressure was found in group A & B at different study timings while statistically significant drop in diastolic blood pressure was only found in group A. Sensory block characteristics were similar among all three groups. Motor block pattern was found marginally significant in group C with highest time to achieve desired block. All patients had satisfactory level of surgical anaesthesia.


CONCLUSIONS
This study concluded that low dose, 6 mg bupivacaine with 20 microg fentanyl provide adequate anaesthesia for surgical repair of hip fracture with stable haemodynamics.
Hoda
Mohammad Qamarul
MQ
Department of Anaesthesiology, Aga Khan University, Karachi.
Saeed
Sabir
S
Afshan
Gauhar
G
Sabir
Salman
S
D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D002045:Bupivacaine / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000627:therapeutic use; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine