International Journal of Medical and Health Research

International Journal of Medical and Health Research


International Journal of Medical and Health Research
International Journal of Medical and Health Research
Vol. 2, Issue 6 (2016)

Original research article: A study of comparative evaluation of bupivacaine plain versus bupivacaine with fentanyl in spinal anaesthesia in geriatric patients


Dr. Sudha Shah, Dr. Bharat Shah, Dr. Chemeli Deb

Background: The undertaking of complex and major surgical procedures on frail elderly patients with multiple disorders has always been and still remains a controversial and enigmatic issue. At the same time, in an increasingly ageing society, the need for such procedures will extend and the patients will expect a more favorable outcome. Surgery in old age will, therefore, pose an ongoing challenge.

Objectives: The aim of the study is comparative evaluation of bupivacaine plain versus bupivacaine with fentanyl in spinal anaesthesia in geriatric patients.

Methodology: This prospective study includes 60 patients of age 65 year or more than 65 year undergoing hip replacement. The study population was randomly allocated to two groups; Group A(n=30) - 15mg of 0.5% bupivacaine & Group B(n=30) - 10mg of 0.5% bupivacaine and 25μg of fentanyl.

Result: Systolic B.P. decreased in both the groups, maximum fall occurred at 15 to 20 min in both the groups: decreases were more severe in group A than in group B,(P<0.O5).heart rates were better maintained in group B than in group A. thus group B showed better hemodynamic stability. Group b had lesser duration of motor blockage without significantly compromising the duration of sensory block or the operative conditions. None of the patients required intraoperative anesthetic supplementation. 8 patients in group B had pruritus while none of the patients developed respiratory depression.

Conclusion: Spinal anesthesia for elderly patients undergoing lower limb surgeries with 2cc bupivacaine 0.5% and 25 μg fentanyl is a safer and better option, both in terms of maintaining hemodynamic stability and lower incidence of complications without compromising the surgical conditions.
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