Using low-dose of bupivacaine in combined spinal and epidural anaesthesia in hip surgery for the elderly

Objective: To evaluate the safety and efficacy of using low-dose of bupivacaine in combined spinal and epiduralanaesthesia( CSEA) in hip surgeries for the elderly. Methods: Sixty elderly patients( ASA physical status Ⅱ to Ⅲ) scheduled for the hip surgery were randomly divided into observation group ( 30 cases，receiving 1 ml of 0. 75% bupivacaine) and control group( 30 cases， receiving 2 ml of 0. 75% bupivacaine) ; CSEA was performed in both groups. The intravenous transfusion and infusion were determined according to the blood pressure and bleeding volume of the patients. The onset time of the sensory block， time to complete block， the highest sensory block level and the number of epidural bupivacaine injections were recorded. The systolic blood pressure， diastolic blood pressure and heart rate before the anesthesia and 5， 15 and 30 minutes after CSEA were observed. Results: There were no significant differences in the onset time of the sensory block， time to complete block and number of epidural bupivacaine injections between the two groups( P ＞ 0. 05) . The changes of the blood pressure of the observation group at 5， 15 and 30 minutes after CSEA were not obvious as compared to those of the control group( P ＜ 0. 05 to P ＜ 0. 01) . The heart rate of the observation group was less affected by anaesthesia at 5 minutes after CSEA than that of the control group( P ＜ 0. 01) . Conclusions: Low-dose of bupivacaine in CSEA may achieve an ideal anesthetic effect and keep a stable hemodynamic status in the elderly patients receving hip surgeries.