COMBINED SPINAL-EPIDURAL ANESTHESIA WITH MINIDOSE BUPIVACAINE-FENTANYL FOR HIP SURGERY IN ELDERLY PATIENTS

Abstract Background: In this study, the effects of mini-dose isobaric bupivacaine with fentanyl on motor and sensory blockade with combined spinal epidural anesthesia were evaluated in patients > 65 years undergoing total hip arthroplasty. Methods: A total of 100 American Society of Anesthesiologists (ASA) class III–IV patients > 65 years were enrolled. The patients received a combined spinal epidural into the intrathecal catheter space of 5 mg 0.5% bupivacaine and 10 µg fentanyl (total 1.1 ml). Levels of sensory and motor blockade, hemodynamic parameters, and the resulting complications were recorded. Results: The mean age of patients (44 females and 56 males) was 79 ± 5.70 (range: 70–93) years. Of the 100 patients, 88 were classified as ASA III and 12 as ASA IV. The average duration of surgery was 59 ± 10 min. Comorbidities in patients with hip prostheses were examined. Heart rate and mean arterial blood pressure values were stable and similar at all times. The time to reach the T10 level of sensory blockade after spinal anesthesia was 10 ± 5.03 min. Motor block regression time was 132.06 ± 14.12 min. Conclusion: An anesthetic technique was applied considering the physiological changes in elderly hip surgery patients. The 5 mg isobaric bupivacaine and 10 µg fentanyl combination provided adequate anesthesia without affecting the hemodynamic parameters.