Bupivacaine Combined With Sufentanil For Clinical Application In Elderly Patients With Spinal Anesthesia

Objective To evaluate the quality of anesthesia and side effect on elderly patients of spinal anesthesia with low dose sufentanil-bupivacaine versus bupivacaine.Methods Ninety patients(60～81yrs,ASAⅠ～Ⅱ) undergoing spinal anesthesia were randomly divided into 3 groups(n=30):Group B₁,B₂ and BS.Group B₁ received 15mg bupivacaine;Group B₂ received 10mg bupivacaine;Group BS received 10mg bupivacaine +5μg sufentanil.The volume was 3ml in every group.SP,DP,HR,RR,BIS,SpO₂,the degree and duration of motor and sensory blockade and the side effect were observed.Resultsâ‘ SP/DP was significantly decreased in Group B₁ than that in Group B₂ and Group BS(P＜0.01) in 3min,5min,15min and 30min after the injection,â‘¡The onset time of sensory blockade,highest sensory blockade level,the regression time of sensory blockade were obviously different in Group B₁,BS than that in Group B₂(P＜0.05).â‘¢The complete recovery time of motor nerve blockade was obviously prolonged in Group B₁ than that in Group B₂,BS (P＜0.01) and the Bromage score was higher in Group B₁ than that in Group B₂,BS(P＜0.05).â‘£There were no significant differences in side effect among the three groups.The dosage of ephedrine was lower in Group BS and B₂ than that in Group B₁(P＜0.05).Conclusion A reduced dose of bupivacaine(10mg) in combination with sufentanil(5μg) provides reliable spinal anesthesia in aged patients with few events of hypotension and little need for vasopressor support of blood pressure.All patients had adequate duration of reliable sensory blocks.Bupivacaine(10mg) with sufentanil increased the duration of postoperative analgesia and induced less motor block compared with bupivacaine(10mg,15mg) without increasing side-effects.This study confirms that Spinal anesthesia with sufentanil-bupivacaine provided safe and effective anesthesia for elderly patients and can be used successfully.