Efficacy of Unilateral Continuous Spinal Anesthesia with Hypobaric Ropivacaine in Elderly Patients Undergoing Hip Replacement

Objective To evaluate the efficacy of unilateral continuous spinal anesthesia with hypobaric ropivacaine in the elderly patients undergoing hip replacement.Methods Sixty elderly patients scheduled for hip replacement were randomly divided into hypobaric ropivacaine group(group HR) and isobaric ropivacaine group(group IR),(n=30 each).The patients in group HR and IR received intrathecal injection with 0.5% hyperbaric ropivacaine 1.0 mL and 0.5% isobaric ropivacaine 1.0 mL at a rate of 0.1 mL/s,respectively.The levels of sensory block and degree of motor block were measured every 5 minutes using a pinprick test and modified Bromage scale respectively.The block level at T8~T10 was maintained with 0.5% ropivacaine by 0.5 mL increments every time.BP,MAP and HR were recorded before intrathecal injection and at the time of the block level reached T8~T10.Adverse reaction,total amount of ropivacaine consumed,duration of analgesia and duration of motor block during operation were recorded.The complications were also recorded during two weeks after operation.Results Compared with group IR,SBP at the time of the block level reached T8~T10 was significantly increased,the total amount of ropivacaine consumed was decreased,duration of analgesia and motor block were both shortened,adverse effects were decreased in group HR(P0.01).No complications were observed after operation in both groups.Conclusion The unilateral continous spinal anesthesia with hypobaric ropivacaine produces controlled sensory block level with stable hemodynamics and less adverse reaction in the elderly patients undergoing hip replacement.