Abstract :
Introduction: The most restricting component of regional anaesthesia in geriatric patients is hypotension inspite of several advantages. The present study aimed to reduce hypotensive effect of local anaesthetics by reducing their dose and by adding fentanyl.
Materials and Methods: We selected 120 elderly patients (?65 years) scheduled for cemented bipolar prosthesis under spinal anaesthesia. They were randomized into two groups (Group - I: n=60, Group - II: n=60). Group I patients received 2.5 ml of 0.5% hyperbaric Bupivacaine and Group II patients received 2 ml of 0.5% hyperbaric Bupivacaine plus 25 µgm fentanyl. Duration of surgery, hemodynamic variables, adverse effect, need for analgesic supplementation were recorded.
Result: Hypotension was more frequent in Group-I than Group-II (83.3% versus 8.33%). Bradycardia is more in Group-I than in Group-II (66.67% versus 5%). Need of I. V. Fentanyl for alleviation of discomfort was same in both groups.
Conclusion: Addition of intrathecal fentanyl provides better hemodynamic stability without compromising quality of anaesthesia.
Keyword :
Analgesia, Bupivacaine, Fentanyl, Geriatric patients, Intrathecal, Spinal anaesthesia.