comparison of fractional versus conventional spinal anesthesia in geriatric patients posted for orthopedic surgery : A Prospective Randomised, double blinded study

Spinal Anaesthesia(SA) frequently performed for lower limb orthopedic surgeries has rapid onset but at the same time, it precipitates hypotension. : Incidence of hypotension during spinal anesthesia for lower limb surgeries in elderly is as high as 92-94% if no preventive measures are taken The rapid onset of spinal anaesthesia can lead to complications such as hypotension, which can be dangerous to the patient, Therefore, recently a fractionated dose injection technique has been developed known as Fractionated Spinal Anesthesia (FSA) in which a local anesthetic agent is given in fractions with a time gap of 60sec-90 sec. This helps in reducing the incidence of hypotension by providing dense blockage with hemodynamic stability and prolonged duration of effective analgesia.Spinal anaesthesia with fractionated method could lead to lower hypotension and bradycardia, longer sensory blockage duration, a more favourable anaesthesia level with lesser complications , in comparision with the bolus method. So, we decided to compare bolus dose conventional spinal versus fractionated dose of bupivacaine in spinal anesthesia for lower limb surgeries in elderly with regard to its effects on incidence of hypotension as our primary objective and Hemodynamic parameters(BP&HR) , block characteristics like Onsent of Sensory and Motor blockade,Duration of sensory and motor blockade Requirments of Vasopressors Time for 1st rescue analgesia Complications in both the groups as well as duration of post-operative analgesia as our secondary objectives.