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In this study, it was planned to provide more stable hemodynamics in geriatric patients with low-dose spinal anesthesia. We will compare 7.5mg hyperbaric bupivacaine with 5mg hyperbaric bupivacaine.
The researchers hypothesized that low-dose bupivacaine would provide adequate anesthesia, less hypotension, and faster recovery.
Hypothesis It is hypothesized that low-dose bupivacaine can provide adequate anesthesia, less hypotension, and faster recovery.
patient population Patients over 65 years of age who will undergo spinal anesthesia due to hip fracture.
Hemodynamic data(Blood pressure-mmHg, heart rate-beats per minute) of patients, bromage scores, perfusion index (PI) values, discharge time, pain with NRS (numerical rating scale), patient satisfaction will be evaluated ( Numeric output from 1-10).
Hemodynamic variables will be recorded every 2 minutes in the first 20 minutes after spinal anesthesia. hemodynamic variables will be recorded 30 minutes after spinal anesthesia and at the end of the operation.
The perfusion index is the ratio of the blood volume to the pulsatile to non-pulsatile fraction. An increase in the pulsatile fraction that occurs during vasodilation corresponds to a higher PI. Therefore, patients with a higher PI have a higher risk of post-spinal hypotension.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 7.5 mg hyperbaric bupivacaine | Active Comparator | Patients undergoing spinal anesthesia in the lateral decubitus position with 7.5 mg of hyperbaric bupivacaine will be included. |
|
| 5 mg hyperbaric bupivacaine | Active Comparator | Patients undergoing spinal anesthesia in the lateral decubitus position with 5 mg of hyperbaric bupivacaine will be included. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 7.5 mg hyperbaric bupivacaine | Other | Spinal anesthesia with 7.5 mg hyperbaric bupivacaine after preoperative peng (pericapsular nerve group) block |
|
| Measure | Description | Time Frame |
|---|---|---|
| hemodynamic variability | intraoperative hemodynamic variables (BP(blood pressure-mmHg) during hip surgery | every 2 minutes for the first 20 minutes after spinal anesthesia |
| hemodynamic variability | intraoperative hemodynamic variables (BP(blood pressure-mmHg) during hip surgery | at 30 minutes of spinal anesthesia |
| Measure | Description | Time Frame |
|---|---|---|
| perfusion index variability | To correlate between perfusion index and hypotension after spinal anaesthesia in hip surgery | every 2 minutes for the first 20 minutes after spinal anesthesia |
| perfusion index variability |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Bilkent City Hospital | Ankara | Çankaya | 06800 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41882562 | Derived | Mafizer M, Kavak Akelma F, Nalbant B. Impact of bupivacaine dose on haemodynamics in elderly hip surgery: a randomized controlled trial. BMC Geriatr. 2026 Mar 26;26(1):630. doi: 10.1186/s12877-026-07374-1. |
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| 5 mg hyperbaric bupivacaine | Other | Spinal anesthesia with 5 mg hyperbaric bupivacaine after preoperative peng (pericapsular nerve group) block |
|
To correlate between perfusion index and hypotension after spinal anaesthesia in hip surgery
| at 30 minutes of spinal anesthesia |
| perfusion index variability | To correlate between perfusion index and hypotension after spinal anaesthesia in hip surgery | at the end of the operation |
| Sensory Levels | Sensory levels will be measured every 30 minutes until discharge from PACU(post-anaesthesia care unit) | 24 hours |
| ephedrine use | ephedrine consumption , mg in hip surgery | 24 hours |
| fentanyl use | fentanyl consumption , mcg in hip surgery | 24 hours |
| bromage scale | Bromage Scores every 30 minutes until discharge from PACU(post-anaesthesia care unit). | 24 hours |
| NRS(numerical rating scale) | pain scoring a score of 1 to 10 | 2 hours |
| NRS(numerical rating scale) | pain scoring a score of 1 to 10 | 8 hours |
| NRS(numerical rating scale) | pain scoring a score of 1 to 10 | 16 hours |
| NRS(numerical rating scale) | pain scoring a score of 1 to 10 | 24 hours |