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Title:
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Spinal Anesthesia with Bupivacaine and Fentanyl in Geriatric Patients
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Author:
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Fernandez-Galinski, Diana; Rué i Monné, Montserrat; Moral, Victoria; Castells, Carmen; Puig, Margarita M.
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Notes:
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We assessed the risks and benefits of the administration
of fentanyl during spinal anesthesia in the elderly.
Forty patients (70-83 yr) undergoing knee or hip replacement
were studied. Preoperatively, cognitive
function (minimental state examination [MMSE]), associated
pathology, medications, and treatment were
evaluated. Patients had spinal anesthesia with 12.5 mg
bupivacaine plus saline (SS; n = 21) or 25 pg fentanyl
(EN; rr = 19). The number of ailments and drugs per
patient were 2.5 and 2.3, respectively; 35%-&l% of disorders
were untreated, 16%-26% were symptomatic,
and 33% were adequately treated. Groups were comparable
regarding demographic data and characteristics
of the spinal block. Group FN had more pruritus (P <
0.02) and lower Sao, (P < 0.007), but prevalence of side
effects was similar. Pain intensity (visual analog scale
[VAS], facial expression test [FET]) at the time of analgesia
request (TAR) was lower in Group FN (P < 0.01).
A poor correlation between VAS and FET (range 0.42-
0.58) was obtained. MMSE at hospital discharge was no
different from preoperative values. Our results show
that 25 kg of spinal fentanyl do not modify spinal anesthesia
in the elderly, but induces pruritus and 0, desaturation.
The decrease in postoperative pain intensity
and the preservation of cognitive function would justify
the use of spinal fentanyl in the elderly. |
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Rights:
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(c) International Anesthesia Research Society, 1996
info:eu-repo/semantics/restrictedAccess |
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Document type:
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article
publishedVersion |
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Published by:
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Lippincott, Williams & Wilkins
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