Spinal anesthesia with low-concentration ropivacaine in elderly patients undergoing lower extremity surgery

Objective To explore the feasibility of spinal anesthesia (SA) with low-concentration ropivacaine in elderly patients undergoing lower extremity surgery. Methods Forty-six patients were randomized to one of the two groups: group A (SA,n=23) and group B (continuous epidural anesthesia CEA,n=23). The patients in both groups were premedicated with luminal 100 mg. In group A , SA was performed at L2-3 or L3-4 interspace. 0.375% ropivacaine 2 ml was injected. In group B, epidural catheter was placed also at L2-3 or L3-4. A test dose of 3ml of 2% lidocaine was injected and then a mixture of 1.0% lidocaine and 0.25% ropivacaine. Degree of motor blockade were measured and recorded. The intraoperative and postoperative complications associated with spinal or epidural anesthesia were recorded. Results In group A, MAP was slightly decreased after initial dose of local anesthetics compared to the baseline MAP in both groups. The incidences of hypotension, which needed treatment with intravenous ephedrine, shivering during operation, and postoperative nausea and vomiting in group A were significantly lower than group B. Conclusions Compared with CEA, SA produced satisfactory sensory block with less hemodynamic changes and less complications. It is the choice for elderly patients undergoing lower extremity surgery.