Does Adding Lidocaine to Intrathecal Bupivacaine Affect Hemodynamic Parameters during Hip Fracture Surgery
محل انتشار: مجله استخوان و جراحی عمومی، دوره: 6، شماره: 5
سال انتشار: 1397
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 308
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شناسه ملی سند علمی:
JR_TABO-6-5_009
تاریخ نمایه سازی: 18 تیر 1398
چکیده مقاله:
Background: Hip fracture is one of the most common problems in elderly that needs surgical repair. As, the majority ofthese patients have chronic diseases, they are at increased risk of peri-operative mortality and morbidity. The purposeof this study was to evaluate spinal anesthesia with bupivacaine vs bupivacaine in combination with lidocaine in termsof hemodynamic changes in patients undergoing hip fracture surgery.Methods: This double-blind clinical trial was conducted on 292 patients undergoing surgery for hip fracture underspinal anesthesia. Patients were allocated into two groups of B (10 mg of hyperbaric 0.5% Bupivacaine) and BL (5 mghyperbaric Bupivacaine 0.5% plus 50 mg Lidocaine 5%). Sensory and motor block and hemodynamic changes wereconsecutively measured before spinal anesthesia (T0), immediately after spinal injection (T1), every 5 minutes for halfan hour (T2- T7), and at 45 minutes (T8) and 60 minutes (T9) after injection.Results: Patients in the two groups were homogeneous in demographic characteristics including age, sex, BMI, ASAClass, baseline blood pressure and heart rate. The onsets of sensory and motor blocks in group BL were faster thangroup B (P=0.0001). Also, the durations of sensory and motor blocks in group B were significantly longer than groupBL (P=0.0001). The BL group had a significantly lower systolic blood pressure in all periods (P<0.05). Although theheart rate in the BL group was lower than group B at all time points, this difference was only significant during T2-T3(P=0.033 and P=0.0001, respectively). Group BL had significantly more episodes of hypotension, bradycardia, nauseaand vomiting (P=0.0001, P=0.023, P=0.003, and P=0.033, respectively).Conclusion: According to our findings, using Lidocaine 50 mg in combination with Bupivacaine 5 mg, compared withBupivacaine 10 mg alone for spinal anesthesia in hip fracture fixation surgeries was associated with more hypotensionand bradycardia. As a result, combination of Bupivacaine with Lidocaine at this dose is not recommended for inductionof anesthesia in these patients.Level of evidence: II
کلیدواژه ها:
نویسندگان
Abbas Sedighinejad
Anesthesiology Research Center, Poursina Hospital, Guilan University of Medical Sciences (GUMS), Rasht, Iran
Bahram Nadei Nabi
Anesthesiology Research Center, Poursina Hospital, Guilan University of Medical Sciences (GUMS), Rasht, Iran
Hossein Ettehad
Orthopedic Research Center, Poursina Hospital, Guilan University of Medical Sciences (GUMS), Rasht, Iran
Ahmadreza Mirbolook
Orthopedic Research Center, Poursina Hospital, Guilan University of Medical Sciences (GUMS), Rasht, Iran