Unilateral spinal anesthesia-epidural anesthesia in elderly patients with hip surgery

Abstract

Objective To observe the effect and safety of unilateral spinal anesthesia-epidural anesthesia for elderly patients with hip surgery. Methods A total of 150 elderly patients scheduled for hip surgery, aged 75 to 101 years old, were randomly divided into three groups :continuous epidural anesthesia group (CEA group), spinal-epidural anesthesia group (CSEA group) and unilateral spinal anesthesia combined with epidural anesthesia group (OCSEA group), 50 cases in each group. Choosing L2-3 or L3-4 intervertebral space as the puncture site, CEA group were epidural administration, blockers of 1.5% lidocaine or 1% lidocaine with 0. 375% bupivacaine, the first agent volume 7-12 ml; CSEA group during the first administration to the subarachnoid epidural catheter was placed supine immediately after the backup 3.5 cm. OCSEA group subarachnoid administration and the first epidural catheter to maintain the lateral position after 10-15 min. Control of anesthesia as the following in T10. CSEA group and OCSEA spinal drug group were 0. 5% hyperbaric bupivacaine solution 1.5-1.7 ml. Comparing three groups of anesthesia, anesthesia and blood pressure changes. Results CSEA group and OCSEA anesthesia were better than the CEA group. The anesthetic plane of CSEA group and OCSEA group were easier to control than that of the CEA group. OCSEA group has more stable blood pressure(P＜0.05).Conclusions 0.5% solution of low dose hyperbaric bupivacaine spinal anesthesia combined with epidural anesthesia unilateral was vary in blood pressure. It is safe and effective, and more suitable for elderly patients with hip surgery anesthesia. Key words: Unilateral spinal anesthesia; Spinal-epidural anesthesia; Epidural anesthesia; Elderly