Bupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery
Abstract Background To evaluate if bupivacaine–fentanyl isobaric spinal anesthesia could reduce the risk of ICU admission compared with general anesthesia in elderly patients undergoing lower limb orthopedic surgery. Methods This study comprised a retrospective review of all lower limb orthopedic su...
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BMC
2024-03-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-024-04618-x |
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| author | Wenxun Liu Shuzhen Bao Jiaxin Chen Yan Li Yinghua Gu Qingshan Ye Kerong Hai |
| author_facet | Wenxun Liu Shuzhen Bao Jiaxin Chen Yan Li Yinghua Gu Qingshan Ye Kerong Hai |
| author_sort | Wenxun Liu |
| collection | DOAJ |
| description | Abstract Background To evaluate if bupivacaine–fentanyl isobaric spinal anesthesia could reduce the risk of ICU admission compared with general anesthesia in elderly patients undergoing lower limb orthopedic surgery. Methods This study comprised a retrospective review of all lower limb orthopedic surgeries performed at our hospital between January 2013 and December 2019. According to anesthesia methods, patients were divided into the spinal anesthesia group (n = 1,728) and the general anesthesia group (n = 188). The primary outcome evaluated was the occurrence of ICU admission. Secondary outcomes included hemodynamic changes, postoperative complications, and mortality. Results Repeated measure analysis of variance indicated that the difference between the two groups in the systolic blood pressure (SBP) was not significant before anesthesia (T0), immediately after anesthesia (T1), and before leaving the operation room (T8) (P > 0.05), but significant (P < 0.01) from 5 min after anesthesia (T2) to after operation (T7). The proportions of ICU admission (6.4% vs. 23.8%, P < 0.01) and unplanned intubation (0.1% vs. 3.8%, P < 0.01) were significantly lower in the spinal anesthesia group compared with those in the general anesthesia group. Multivariate logistic regression revealed that after controlling for potential confounding factors, the odds of ICU admission for patients in the spinal anesthesia group was 0.240 times (95% CI 0.115–0.498; P < 0.01) than those in the general anesthesia group. Conclusions Bupivacaine–fentanyl isobaric spinal anesthesia significantly reduced the risk of ICU admission and unplanned intubation, and provided better intraoperative hemodynamics in elderly patients undergoing lower limb orthopedic surgery. Trial registration: This study has been registered in the Chinese Clinical Trial Registry (ChiCTR2000033411). |
| format | Article |
| id | doaj-art-2c6fbbeccc1a47c0848c6dea763a7d91 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-2c6fbbeccc1a47c0848c6dea763a7d912025-02-09T12:47:08ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2024-03-011911510.1186/s13018-024-04618-xBupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgeryWenxun Liu0Shuzhen Bao1Jiaxin Chen2Yan Li3Yinghua Gu4Qingshan Ye5Kerong Hai6Department of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous RegionDepartment of Anesthesiology, Ganzhou People’s HospitalNingxia Medical UniversityNingxia Medical UniversityNingxia Medical UniversityDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous RegionDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous RegionAbstract Background To evaluate if bupivacaine–fentanyl isobaric spinal anesthesia could reduce the risk of ICU admission compared with general anesthesia in elderly patients undergoing lower limb orthopedic surgery. Methods This study comprised a retrospective review of all lower limb orthopedic surgeries performed at our hospital between January 2013 and December 2019. According to anesthesia methods, patients were divided into the spinal anesthesia group (n = 1,728) and the general anesthesia group (n = 188). The primary outcome evaluated was the occurrence of ICU admission. Secondary outcomes included hemodynamic changes, postoperative complications, and mortality. Results Repeated measure analysis of variance indicated that the difference between the two groups in the systolic blood pressure (SBP) was not significant before anesthesia (T0), immediately after anesthesia (T1), and before leaving the operation room (T8) (P > 0.05), but significant (P < 0.01) from 5 min after anesthesia (T2) to after operation (T7). The proportions of ICU admission (6.4% vs. 23.8%, P < 0.01) and unplanned intubation (0.1% vs. 3.8%, P < 0.01) were significantly lower in the spinal anesthesia group compared with those in the general anesthesia group. Multivariate logistic regression revealed that after controlling for potential confounding factors, the odds of ICU admission for patients in the spinal anesthesia group was 0.240 times (95% CI 0.115–0.498; P < 0.01) than those in the general anesthesia group. Conclusions Bupivacaine–fentanyl isobaric spinal anesthesia significantly reduced the risk of ICU admission and unplanned intubation, and provided better intraoperative hemodynamics in elderly patients undergoing lower limb orthopedic surgery. Trial registration: This study has been registered in the Chinese Clinical Trial Registry (ChiCTR2000033411).https://doi.org/10.1186/s13018-024-04618-xSpinal anesthesiaGeneral anesthesiaLower limb orthopedic surgeryIntensive care unitHemodynamics |
| spellingShingle | Wenxun Liu Shuzhen Bao Jiaxin Chen Yan Li Yinghua Gu Qingshan Ye Kerong Hai Bupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery Journal of Orthopaedic Surgery and Research Spinal anesthesia General anesthesia Lower limb orthopedic surgery Intensive care unit Hemodynamics |
| title | Bupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery |
| title_full | Bupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery |
| title_fullStr | Bupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery |
| title_full_unstemmed | Bupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery |
| title_short | Bupivacaine–fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery |
| title_sort | bupivacaine fentanyl isobaric spinal anesthesia reduces the risk of icu admission in elderly patients undergoing lower limb orthopedic surgery |
| topic | Spinal anesthesia General anesthesia Lower limb orthopedic surgery Intensive care unit Hemodynamics |
| url | https://doi.org/10.1186/s13018-024-04618-x |
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