The Effect of Spinal Anesthesia on Hemodynamics
Study Details
Study Description
Brief Summary
In this study, it was planned to provide more stable hemodynamics in geriatric patients with low-dose spinal anesthesia. We will compare 7.5mg hyperbaric bupivacaine with 5mg hyperbaric bupivacaine.
The researchers hypothesized that low-dose bupivacaine would provide adequate anesthesia, less hypotension, and faster recovery.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Hypothesis It is hypothesized that low-dose bupivacaine can provide adequate anesthesia, less hypotension, and faster recovery.
patient population Patients over 65 years of age who will undergo spinal anesthesia due to hip fracture.
Hemodynamic data(Blood pressure-mmHg, heart rate-beats per minute) of patients, bromage scores, perfusion index (PI) values, discharge time, pain with NRS (numerical rating scale), patient satisfaction will be evaluated ( Numeric output from 1-10).
Hemodynamic variables will be recorded every 2 minutes in the first 20 minutes after spinal anesthesia. hemodynamic variables will be recorded 30 minutes after spinal anesthesia and at the end of the operation.
The perfusion index is the ratio of the blood volume to the pulsatile to non-pulsatile fraction. An increase in the pulsatile fraction that occurs during vasodilation corresponds to a higher PI. Therefore, patients with a higher PI have a higher risk of post-spinal hypotension.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: 7.5 mg hyperbaric bupivacaine Patients undergoing spinal anesthesia in the lateral decubitus position with 7.5 mg of hyperbaric bupivacaine will be included. |
Other: 7.5 mg hyperbaric bupivacaine
Spinal anesthesia with 7.5 mg hyperbaric bupivacaine after preoperative peng (pericapsular nerve group) block
|
| Active Comparator: 5 mg hyperbaric bupivacaine Patients undergoing spinal anesthesia in the lateral decubitus position with 5 mg of hyperbaric bupivacaine will be included. |
Other: 5 mg hyperbaric bupivacaine
Spinal anesthesia with 5 mg hyperbaric bupivacaine after preoperative peng (pericapsular nerve group) block
|
Outcome Measures
Primary Outcome Measures
- hemodynamic variability [every 2 minutes for the first 20 minutes after spinal anesthesia]
intraoperative hemodynamic variables (BP(blood pressure-mmHg) during hip surgery
- hemodynamic variability [at 30 minutes of spinal anesthesia]
intraoperative hemodynamic variables (BP(blood pressure-mmHg) during hip surgery
Secondary Outcome Measures
- perfusion index variability [every 2 minutes for the first 20 minutes after spinal anesthesia]
To correlate between perfusion index and hypotension after spinal anaesthesia in hip surgery
- perfusion index variability [at 30 minutes of spinal anesthesia]
To correlate between perfusion index and hypotension after spinal anaesthesia in hip surgery
- perfusion index variability [at the end of the operation]
To correlate between perfusion index and hypotension after spinal anaesthesia in hip surgery
- Sensory Levels [24 hours]
Sensory levels will be measured every 30 minutes until discharge from PACU(post-anaesthesia care unit)
- ephedrine use [24 hours]
ephedrine consumption , mg in hip surgery
- fentanyl use [24 hours]
fentanyl consumption , mcg in hip surgery
- bromage scale [24 hours]
Bromage Scores every 30 minutes until discharge from PACU(post-anaesthesia care unit).
- NRS(numerical rating scale) [2 hours]
pain scoring a score of 1 to 10
- NRS(numerical rating scale) [8 hours]
pain scoring a score of 1 to 10
- NRS(numerical rating scale) [16 hours]
pain scoring a score of 1 to 10
- NRS(numerical rating scale) [24 hours]
pain scoring a score of 1 to 10
Eligibility Criteria
Criteria
Inclusion Criteria:
-
ASA(American Society of Anesthesiologists) I-II-III patients
-
BMI( body mass index) in the range of 18-40
-
over 65 years old hip fracture
Exclusion Criteria:
-
Refusal to participate in the study
-
Left ventricular ejection fraction below 40%
-
cardiac arrhythmia
-
Patients with peripheral vascular disease
-
Failure of spinal anesthesia
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Ankara Bilkent City Hospital | Ankara | Çankaya | Turkey | 06800 |
Sponsors and Collaborators
- Ankara City Hospital Bilkent
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- geriatrics