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Fırat Tıp Dergisi
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What is the Optimal Dose of Isobaric Bupivacaine for Spinal Anesthesia in Elderly Patients Undergoing Transurethral Resection?
Aysun YILDIZ ALTUN1, Demet COŞKUN2, Füsun BOZKIRLI3
1Fırat Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Elazığ, Türkiye
2Gazi Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye
3Toros Üniversitesi Meslek Yüksek Okulu, Anesteziyoloji ve Reanimasyon, Mersin, Türkiye

Objective: Elderly patients show higher susceptibility to hemodynamic instability and other distinct responses under spinal anesthesia than younger patients. The purpose of the present study was to compare the characteristics of subarachnoid block, intensity of postoperative analgesia, and side effects among elderly patients receiving 5, 7.5, or 10 mg of isobaric bupivacaine combined with 100-μg morphine for transurethral resection of pros-tate (TUR P).

Material and Method: Sixty patients undergoing TUR P were randomly assigned to one of three groups n =20 each receiving intrathecal isobaric bupivacaine at either 5 mg (Group Bup5), 7.5 mg (Group Bup7.5), or 10 mg (Group Bup10). In all groups, 100-μg morphine was added to isobaric bupivacaine. The onset and recovery times of sensory block, degree and maximum time of motor block, side effects, and quality of postoperative analgesia were recorded and compared among groups.

Results: Maximum sensorial blockade levels were T10 in Group Bup5, T8 in Group Bup7.5, and T6 in Group Bup10. The two-segment regression time, mobilization time, and time to the first postoperative analgesic requirement were shortest in Group Bup5 (p <0.001). The incidence of hemody-namic instability was highest in Group Bup10 (p <0.001).

Conclusion: In elderly TUR patients, the combination of 7.5-mg isobaric bupivacaine plus 100-μg morphine may provide a better quality of spinal anesthesia and postoperative analgesia without causing major side effects compared to administration of 5 or 10 mg of isobaric bupivacaine plus the same dose of morphine.


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