Intrathecal Fentanyl with Small-Dose Bupivacaine: Stable Hemodynamics in Geriatric Population Undergoing Orthopedic Surgery

Abstract

Fentanyl (FNL) has been used since long for the management of intense pain due to cancerous and non-cancerous diseases. Bupivacaine (BVP) is also a widely used local anesthetic used in surgery and obstetrics Objective: To examine the clinical effect of small-dose (20 mcg) fentanyl added to spinal anesthesia with small-dose dilute bupivacaine (6 mg of 0.7% bupivacaine) on anesthesia quality and recovery. Methods: This study was conducted in Ayub Teaching Hospital after taking the ethical approval from hospital review board.  Informed consent was obtained from all patients. Patients accepted for the study were all ASA I or II physical status presenting for ambulatory arthroscopic surgery of the knee. Sample size of 60 were determined by power analysis based on standard deviation data from our previously published report, P % 0.05, and the assumption of a 90% power to detect a 30-min difference in mean time to complete sensory recovery. Results: Total 60 patients were enrolled in current study. The mean age of patients was 78.52+8.22. There were 47(78.3%) male and 13(21.7%) were female. The hemodynamic changes from start of the procedure after 30 minutes were noted. The mean systolic blood pressure at base line was 120.65+18.197 and at 30 minutes was 118.98+14.39. The mean diastolic blood pressure at base line was 74.83+16.569 and at 30 minutes was 73.70+13.41. The mean heart rate at base line was 62.73+5.90 and at 30 minutes was 62.61+5.87. The mean heart rate at base line was 89.72+16.728 and at 30 minutes was 88.38+13.26 Conclusion: Myocardial infarction was the leading cause of postoperative death.