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Bupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery.
- Source :
- Journal of Orthopaedic Surgery & Research; 3/1/2024, Vol. 19 Issue 1, p1-5, 5p
- Publication Year :
- 2024
-
Abstract
- Background: To evaluate if bupivacaine–fentanyl isobaric spinal anesthesia could reduce the risk of ICU admission compared with general anesthesia in elderly patients undergoing lower limb orthopedic surgery. Methods: This study comprised a retrospective review of all lower limb orthopedic surgeries performed at our hospital between January 2013 and December 2019. According to anesthesia methods, patients were divided into the spinal anesthesia group (n = 1,728) and the general anesthesia group (n = 188). The primary outcome evaluated was the occurrence of ICU admission. Secondary outcomes included hemodynamic changes, postoperative complications, and mortality. Results: Repeated measure analysis of variance indicated that the difference between the two groups in the systolic blood pressure (SBP) was not significant before anesthesia (T0), immediately after anesthesia (T1), and before leaving the operation room (T8) (P > 0.05), but significant (P < 0.01) from 5 min after anesthesia (T2) to after operation (T7). The proportions of ICU admission (6.4% vs. 23.8%, P < 0.01) and unplanned intubation (0.1% vs. 3.8%, P < 0.01) were significantly lower in the spinal anesthesia group compared with those in the general anesthesia group. Multivariate logistic regression revealed that after controlling for potential confounding factors, the odds of ICU admission for patients in the spinal anesthesia group was 0.240 times (95% CI 0.115–0.498; P < 0.01) than those in the general anesthesia group. Conclusions: Bupivacaine–fentanyl isobaric spinal anesthesia significantly reduced the risk of ICU admission and unplanned intubation, and provided better intraoperative hemodynamics in elderly patients undergoing lower limb orthopedic surgery. Trial registration: This study has been registered in the Chinese Clinical Trial Registry (ChiCTR2000033411). [ABSTRACT FROM AUTHOR]
- Subjects :
- PREVENTION of surgical complications
LEG surgery
COMBINATION drug therapy
SPINAL anesthesia
MORTALITY
PATIENTS
HOSPITAL admission & discharge
HEMODYNAMICS
SURGICAL therapeutics
RETROSPECTIVE studies
DESCRIPTIVE statistics
ORTHOPEDIC surgery
SURGICAL complications
TRACHEA intubation
INTENSIVE care units
MEDICAL records
ACQUISITION of data
GENERAL anesthesia
COMPARATIVE studies
BUPIVACAINE
FENTANYL
OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 1749799X
- Volume :
- 19
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Orthopaedic Surgery & Research
- Publication Type :
- Academic Journal
- Accession number :
- 175829315
- Full Text :
- https://doi.org/10.1186/s13018-024-04618-x