The safety and effect of hypobaric and hyperbaric bupivacaine in combined spinal-epidural anesthesia for elderly patients with lower limb surgery

Objective To compare the efficacy and safety of hypobaric and hyperbaric bupivacaine in combined spinal-epidural anesthesia for elderly patients with lower extremity surgery. Methods A total of 72 patients underwent lower limb surgery were randomly divided into control group and observation group according to the digital table, 36 patients in each group.The patients were given hypobaric or hyperbaric bupivacaine in combined spinal-epidural anesthesia.The anesthesia effect during surgery and hemodynamics related indicators were compared between the two groups, and the intraoperative and postoperative anesthesia-related adverse reactions were recorded. Results The excellent and good rate of sedation in the observation group was 88.91% (32/36), which in the control group was 91.67% (33/35), the difference was not statistically significant (χ2=0.16, P=0.69). The incidence rates of adverse events of the observation group, including back pain, urinary retention and neurological symptoms were significantly lower than those of the control group (all P<0.05). Conclusion The effect of hypobaric bupivacaine is excellent, the effect of hemodynamics is small, the postoperative circulatory system is relatively stable, the operation safety is better, it is superior to the middle and elderly patients with lower limb surgery anesthesia. Key words: Anesthesia, Epidural; Aged; Safety