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Hemodynamic impact of isobaric levobupivacaine versus hyperbaric bupivacaine for subarachnoid anesthesia in patients aged 65 and older undergoing hip surgery

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Hemodynamic impact of isobaric levobupivacaine versus hyperbaric bupivacaine for subarachnoid anesthesia in patients aged 65 and older undergoing hip surgery

dc.contributor.author	Herrera, Rosa	es_ES
dc.contributor.author	De Andrés Ibáñez, José	es_ES
dc.contributor.author	Estañ, Luis	es_ES
dc.contributor.author	Morales Olivas, Francisco J.	es_ES
dc.contributor.author	Martínez Mir, Inocencia	es_ES
dc.contributor.author	Steinfeldt, Thorsten	es_ES
dc.date.accessioned	2015-06-10T09:48:28Z
dc.date.available	2015-06-10T09:48:28Z
dc.date.issued	2014
dc.date.issued	2014
dc.date.issued	2014
dc.identifier.citation	BMC Anesthesiology Vol. 14	es_ES
dc.identifier.uri	http://hdl.handle.net/10550/44293
dc.description.abstract	BackgroundThe altered hemodynamics, and therefore the arterial hypotension is the most prevalent adverse effect after subarachnoid anesthesia. The objective of the study was to determine the exact role of local anesthetic selection underlying spinal anesthesia-induced hypotension in the elderly patient. We conducted a descriptive, observational pilot study to assess the hemodynamic impact of subarachnoid anesthesia with isobaric levobupivacaine versus hyperbaric bupivacaine for hip fracture surgery.DescriptionHundred twenty ASA status I-IV patients aged 65 and older undergoing hip fracture surgery were enrolled. The primary objective of our study was to compare hemodynamic effects based on systolic blood pressure (SBP) and dyastolic blood pressure (DBP) values, heart rate (HR) and hemoglobin (Hb) and respiratory effects based on partial oxygen saturation (SpO2%) values. The secondary objective was to assess potential adverse events with the use of levobupivacaine versus bupivacaine. Assessments were performed preoperatively, at 30 minutes into surgery, at the end of anesthesia and at 48 hours and 6 months after surgery.Among intraoperative events, the incidence of hypotension was statistically significantly higher (p <0.05) in group BUPI (38.3%) compared to group LEVO (13.3%). There was a decrease (p <0.05) in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 30 minutes intraoperatively (19% in group BUPI versus 17% in group LEVO). SpO2% increased at 30 minutes after anesthesia onset (1% in group BUPI versus 1.5% in group LEVO). Heart rate (HR) decreased at 30 minutes after anesthesia onset (5% in group BUPI versus 9% in group L). Hemoglobin (Hb) decreased from time of operating room (OR) admission to the end of anesthesia (9.3% in group BUPI versus 12.5% in group LEVO). The incidence of red blood cell (RBC) transfusion was 13.3% in group BUPI versus 31.7% in group LEVO, this difference was statistically significant. Among postoperative events, the incidence of congestive heart failure (CHF) was significantly higher in group BUPI (8,3%). At 6 months after anesthesia, no differences were found.ConclusionsGiven the hemodynamic stability and lower incidence of intraoperative hypotension observed, levobupivacaine could be the agent of choice for subarachnoid anesthesia in elderly patients.	es_ES
dc.subject	Elderly	es_ES
dc.subject	Hip fracture	es_ES
dc.subject	Subarachnoid block	es_ES
dc.subject	Levobupivacaine	es_ES
dc.subject	Bupivacaine	es_ES
dc.title	Hemodynamic impact of isobaric levobupivacaine versus hyperbaric bupivacaine for subarachnoid anesthesia in patients aged 65 and older undergoing hip surgery	es_ES
dc.type	journal article	es_ES
dc.identifier.doi	10.1186/1471-2253-14-97	es_ES
dc.identifier.idgrec	100693	es_ES