Comparison of Unilateral Spinal and General Anaesthesia in Total Hip Operations: A Prospective Controlled Study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 3
Abstract
Hip fractures are common, potentially devastating events for elderly patients. Hip fractures are usually treated in hospital with surgery so these patients will need anaesthesia. The impact of anaesthetic techniques in patients experiencing hip fracture is controversial. This study was conducted to compare the effects of two anaestehic techniques: unilateral spinal and general anaesthesia on haemodynamy and postoperative cognitive disfunction (POCD) in elderly patients undergoing hip surgery. Fifty two American Society of Anesthesiologists (ASA) II-III patients, aged between 60-85 years, undergoing hip fracture repair were randomly allocated to receive; unilateral spinal anaesthesia with 7.5 mg 0.5 % hyperbaric bupivacaine (Group USpA, n=26) or general anaesthesia (Group GA, n=26). After maintaining the lateral position for 15 minutes sensorial block levels and motor block degrees were determined at 5, 15, 30 and 45 minutes in group USpA and haemodynamic parameters were determined at 5, 10, 15, 30, 45 and 60 minutes in both groups. POCD was evaluated preoperatively, postoperative 1st day and 3rd month. After 15 minutes 73.3% unilateral spinal anaesthesia was achieved in Group USpA. This ratio was found to be 60% after 30 minutes. Systolic and diastolic blood pressure values were significantly lower than initial values in Group USpA at 5. and 10. minutes and at the 45. minute in Group GA. In group comparisons there was a significant difference in haemodynamic parameters at 5. and 45. minutes. POCD was significantly higher in Group GA than Group USpA in postoperative 1st day but the difference was not significant in postoperative 3rd months. Unilateral spinal anaesthesia generate similar haemodynamic changes compared to general anaesthesia. Besides the effects on POCD similar to general anaesthesia. It was concluded that in elderly patients with high anaesthesia risk unilateral spinal and general anaesthesia have comparable effects. Keywords: Anaesthesia, unilateral spinal, general; replacement, hip.
Authors and Affiliations
G. Ulufer Sivrikaya, Nevşin B. Arda, Ayse Hanci, Metin Bektas, Banu Burgutoglu
Keywords
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