2022, Number 2
Spinal anesthesia with bupivacaine plus morphine in urgent intertrochanteric hip fracture surgery
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Language: Spanish
References: 22
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ABSTRACT
Introduction: Hip fracture in the elderly patient is a frequent entity with a high incidence worldwide and in Cuba due to aging.Objective: To assess the efficacy of spinal anesthesia with bupivacaine plus morphine in intertrochanteric hip fracture surgery.
Methods: A clinical, experimental, nonrandomized, prospective, prospective and longitudinal study was carried out in Faustino Pérez Hernández University Hospital of Matanzas, from October 2017 to October 2019. The universe consisted of all surgical patients with hip fracture attended in the hospital. The sample was made by purposive sampling, consisting of 120 patients chosen at the discretion of the researchers. The control group (B) was administered subarachnoid anesthesia with 10 mg of bupivacaine 0.5 %. The study group (M) was administered subarachnoid anesthesia with 7 mg of bupivacaine 0.5 % plus 0.2 mg of morphine. Each group consisted of 60 patients. The following variables were analyzed: age groups, gender, physical condition, puncture level, motor block onset time, arterial hypotension, use of vasopressors, and complications secondary to the anesthetic technique.
Results: The predominant age group was 84 and 90 years old, together with female gender and ASA III. Lumbar puncture was performed between L3 and L4. The motor block onset time was 1.3 times shorter in the M group. Arterial hypotension prevailed in the B group; apart from the use of vasopressors in both groups. As complications, there was a predominance of pruritus in the M group and bradycardia in the B group.
Conclusions: The association bupivacaine/morphine in spinal anesthesia for hip fracture among elderly adults provides better outcomes without major complications.
REFERENCES
Cabarique Serrano SH, González Cárdenas VH, Dussán Crosby JP, Páez González RE, Ramírez MA. Anestesia epidural para artrodesis e instrumentación de columna lumbar por vía posterior en paciente con tromboastenia de glanzmann - informe de caso y revisión sistemática. Rev. Colomb. Anestesiol. 2016[acceso: 05/05/2021];44(3):149-254. Disponible en: Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-33472016000300012&lng=es 10.
Alonso C, Cruz Prado P, Álvarez Grau J, Pachoco Jiménez A, Arregui Martínez de Lejarsa A, Sánchez García ML, et al. Comparación de la respuesta hemodinámica en la anestesia subaracnoidea con Bupivacaína frente a Bupivacaína con fentanyl en cirugía traumatología en ancianos. Rev Española Anestesiol Reanim. 2003;50(1):17-22.
Bathari R, Bhalotra AR, Anand R, Kumar V. A randomiszed trial to compare the effect of addition of clonidine of fentanyl to hyperbaric ropivacaine for spinal anastheia for knee arthroscopy a randomiosed trial to compare the effect of addition of clonidine or fentanyl to hyperbaric ropivacaine for South African J Anesth Analg. 2016;21(5):138-42.
Rego Hernández JJ, Hernández Seurat CA, Andreu Fernández AM, Lima Beltrán ML, Torres Lahera ML, Vázquez Martínez M, et al. Factores asociados a la fractura de cadera en el hospital Clínico Quirúrgico "Salvador Allende". Rev Cubana de Salud Pública. 2017[acceso: 05/01/2020];43(2):155-56. Disponible en: Disponible en: http://www.scielo.sld.cu 16.
Bathari R, Bhalotra AR, Anand R, Kumar V. A randomiszed trial to compare the effect of addition of clonidine of fentanyl to hyperbaric ropivacaine for spinal anastheia for knee arthroscopy a randomiosed trial to compare the effect of addition of clonidine or fentanyl to hyperbaric ropivacaine for South African J Anesth Analg. 2016;21(5):138-42.