[Continuous spinal anesthesia in very elderly patients with high anesthesia risk in traumatologic-orthopedic and general surgery interventions].

Abstract

Continuous spinal anaesthesia (CSA) was carried out via a 28-gauge spinal catheter in 154 surgical patients at the Department of Anaesthesiology and Critical Care at Radeberg Asklepios-ASB Hospital between May 1992 and March 1999. The method was used preferably in patients aged over 70 (mean age 82.3 years) with high general risk during anaesthesia (ASA III-IV) who underwent orthopaedic or general surgery of the lower limb and hypogastrium. Remarkably, an anaesthetic level of between Th 8 and Th 10 was achieved with the low initial dose of 7.5 mg of 0.5% hyperbaric bupivacaine. Only minimal cardiovascular and respiratory side-effects were observed in comparison to single shot spinal and general anaesthesia. In the whole series, no anaesthesia-related complications were seen. Another benefit of CSA is the option of applying a second dose with longer duration of surgery to keep the optimal anaesthetic level. In addition, the method is suitable for postoperative analgesia over a period of 2 to 3 days.