The comparison of novel epidural volume extension on hemodynamic response with traditional spinal anaesthesia in elderly Indian patients undergoing orthopedic surgery: A prospective observational study
Snehal M. Salve, Harsha H. Narkhede, Manisha Sapate, Aafreen AnsariIntroduction:
Traditional spinal anesthesia produces significant levels of sensory block leading to spinal hypotension in the elderly population that affects the clinical outcomes postoperatively. Hence, the epidural volume extension (EVE) technique, a variation of combined spinal epidural anesthesia, is used on elderly patients to avoid the abrupt hypotension brought on by the higher level of sensory blockade in spinal anesthesia. Here, we compare the hemodynamic response following EVE technique and spinal anesthesia.
Materials and Methods:
In this study, 108 patients of age >60 years were divided into two groups: Group EVE receiving combined spinal epidural anesthesia, 10 ml saline was injected in epidural space after low dose spinal anesthesia and Group nonepidural volume extension (NVE) received spinal anesthesia only. The primary outcome was hemodynamic stability. Secondary outcomes were maximum levels of sensory block, motor block, two-segment regression time, duration of analgesia, total analgesic doses consumed in 24 h, and adverse effects if any.
Results:
In Group NVE, the mean arterial pressure (MAP) at 1 h was 88.28 and 86.73 in group EVE which was statistically significant (Friedman Test:
Conclusion:
EVE approach offers superior hemodynamic stability following induction than spinal anesthesia.