The Effect of Spinal Anesthesia Methods on Hemodynamics in Geriatric Patients
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Ankara City Hospital Bilkent
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- hemodynamic variability
Study Overview
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.
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
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Other
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 65 Years to — (Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
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
Arms & Interventions
7.5 mg hyperbaric bupivacaine
Patients undergoing spinal anesthesia in the lateral decubitus position with 7.5 mg of hyperbaric bupivacaine will be included.
Intervention: 7.5 mg hyperbaric bupivacaine (Other)
5 mg hyperbaric bupivacaine
Patients undergoing spinal anesthesia in the lateral decubitus position with 5 mg of hyperbaric bupivacaine will be included.
Intervention: 5 mg hyperbaric bupivacaine (Other)
Outcomes
Primary Outcomes
hemodynamic variability
Time Frame: at 30 minutes of spinal anesthesia
intraoperative hemodynamic variables (BP(blood pressure-mmHg) during hip surgery
hemodynamic variability
Time Frame: every 2 minutes for the first 20 minutes after spinal anesthesia
intraoperative hemodynamic variables (BP(blood pressure-mmHg) during hip surgery
Secondary Outcomes
- Sensory Levels(24 hours)
- ephedrine use(24 hours)
- fentanyl use(24 hours)
- bromage scale(24 hours)
- perfusion index variability(at the end of the operation)
- NRS(numerical rating scale)(24 hours)
- perfusion index variability(every 2 minutes for the first 20 minutes after spinal anesthesia)
- perfusion index variability(at 30 minutes of spinal anesthesia)
- NRS(numerical rating scale)(2 hours)
- NRS(numerical rating scale)(8 hours)
- NRS(numerical rating scale)(16 hours)
Investigators
Fatma Kavak Akelma
Anesthesiology and reanimation assistant doktor
Ankara City Hospital Bilkent