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Revista Cubana de Anestesiología y Reanimación
versión On-line ISSN 1726-6718
Resumen
HERNANDEZ RODRIGUEZ, Javier et al. Spinal anesthesia with bupivacaine plus morphine in urgent intertrochanteric hip fracture surgery. Rev cuba anestesiol reanim [online]. 2022, vol.21, n.2 Epub 20-Jun-2022. ISSN 1726-6718.
Introduction:
Hip fracture in the elderly patient is a frequent entity with a high incidence worldwide and in Cuba due to aging.
Objective:
To assess the efficacy of spinal anesthesia with bupivacaine plus morphine in intertrochanteric hip fracture surgery.
Methods:
A clinical, experimental, nonrandomized, prospective, prospective and longitudinal study was carried out in Faustino Pérez Hernández University Hospital of Matanzas, from October 2017 to October 2019. The universe consisted of all surgical patients with hip fracture attended in the hospital. The sample was made by purposive sampling, consisting of 120 patients chosen at the discretion of the researchers. The control group (B) was administered subarachnoid anesthesia with 10 mg of bupivacaine 0.5 %. The study group (M) was administered subarachnoid anesthesia with 7 mg of bupivacaine 0.5 % plus 0.2 mg of morphine. Each group consisted of 60 patients. The following variables were analyzed: age groups, gender, physical condition, puncture level, motor block onset time, arterial hypotension, use of vasopressors, and complications secondary to the anesthetic technique.
Results:
The predominant age group was 84 and 90 years old, together with female gender and ASA III. Lumbar puncture was performed between L3 and L4. The motor block onset time was 1.3 times shorter in the M group. Arterial hypotension prevailed in the B group; apart from the use of vasopressors in both groups. As complications, there was a predominance of pruritus in the M group and bradycardia in the B group.
Conclusions:
The association bupivacaine/morphine in spinal anesthesia for hip fracture among elderly adults provides better outcomes without major complications.
Palabras clave : elderly; hip fracture; spinal anesthesia; bupivacaine; morphine.