Hypobaric Spinal Anesthesia with Ropivacaine Plus Sufentanil for Traumatic Femoral Neck Surgery in the Elderly

Lilot, Marc; Meuret, Pascal; Bouvet, Lionel; Caruso, Liana; Dabouz, R.; Deléat-Besson, Robert; Rousselet, Bernard; Thouverez, B.; Zadam, A.; Allaouchiche, Bernard; Boselli, Emmanuel

doi:10.1213/ane.0b013e31828f29f8

Cited by 15 publications

(12 citation statements)

References 22 publications

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“…Sufentanil is a type of narcotic drug and opioid receptor agonist, and contains citrate as the main pharmacological component ( 2 – 4 ). Sufentanil is easily transferred through the blood-brain barrier with its high lipid solubility, and can bind with plasma protein for a good analgesic effect, with a longer interval for anesthesia ( 12 , 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…Currently, laparoscopic radical resection is the most widely used clinical treatment for colorectal cancer, however, it causes great discomfort for the patient ( 2 ). To improve the quality of anesthesia in the laparoscopic radical resection of colorectal cancer is a challenge for the medical field ( 3 , 4 ). Target-controlled infusion (TCI) is a new approach of anesthesia.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of recovery effect for sufentanil and remifentanil anesthesia with TCI in laparoscopic radical resection during colorectal cancer

Yao

Zhang

et al. 2016

Oncology Letters

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The aim of the present study was to compare the recovery of sufentanil and remifentanil anesthesia by target-controlled infusion (TCI) in elderly patients with laparoscopic-assisted radical resection of colorectal cancer. The effect of anesthesia on patient stress response and cellular immune function was also observed. Elderly patients (n=192) who underwent laparoscopic radical resection of colorectal cancer between July 2014 and October 2015 were randomly divided into the sufentanil and remifentanil groups (n=96 per group). The two groups used sufentanil- and remifentanil-based anesthesia by TCI. The wake-up time, extubation time, orientation recovery time, vital signs, stress response, distribution of T-cell subsets and incidence of adverse reactions were recorded and compared. The wake-up and extubation times of the remifentanil group were significantly shorter than those of the sufentanil group. The difference of orientation recovery time was not statistically significant. The differences in heart rate, mean arterial pressure, and arterial oxygen saturation following anesthesia and during surgery and those prior to anesthesia of the sufentanil group were not statistically significant. However, those of the remifentanil group significantly improved following anesthesia. The concentrations of glucose, cortisol (COR), and interleukin-6 and C-reactive protein were stable in the sufentanil group, whereas the indices in the remifentanil group had a tendency of increasing during the anesthesia and surgery, and had a longer postoperative recovery time. The decreasing degree of T-cell subsets in the sufentanil group was significantly lower than that in the remifentanil group, and had a short recovery of cellular immunity following surgery. The adverse reactions rate during anesthesia of the remifentanil group was significantly higher than that of the sufentanil group. In conclusion, sufentanil- and remifentanil-based anesthesia with TCI has certain advantages, including improved recovery effect, less stress response, less inhibition of cellular immunity and fewer adverse reactions. It has the potential to become the first choice of anesthetic in the clinic for elderly patients who undergo laparoscopic radical resection for colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of recovery effect for sufentanil and remifentanil anesthesia with TCI in laparoscopic radical resection during colorectal cancer

Yao

Zhang

et al. 2016

Oncology Letters

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“…Recent study demonstrated that a dermatome level up to T12 may satisfy the requirement of surgical anesthesia for hip replacement [21]. The nerves innervating the hip joints derived from the ventral rami of the spinal nerve roots of the lower part of the lumbar plexus (L2-4) and the upper part of the sacral plexus (L4-S1) [22].…”

Section: Discussionmentioning

confidence: 99%

Surgical anesthesia with a combination of T12 paravertebral block and lumbar plexus, sacral plexus block for hip replacement in ankylosing spondylitis: CARE-compliant 4 case reports

Liu

et al. 2017

BMC Anesthesiol

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BackgroundAnesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block.Case presentationFour patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints. A combination of T12 paravertebral block, lumbar plexus and sacral plexus block was successfully used for the surgery without any additional intravenous anesthetic or local anesthetics infiltration to the incision, and none of the patients complained of discomfort during the operations.ConclusionsThe combination of T12 paravertebral block, lumbar plexus and sacral plexus block, which may block all nerves innervating the articular capsule, surrounding muscles and the skin involved in total hip arthroplasty, might be a promising alternative for total hip arthroplasty in ankylosing spondylitis.

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“…1 The reduction of local anesthetic dose (adding adjuvants like opioids) and sympathectomy can contribute to more favourable haemodynamics and theoretically better outcomes in the elderly population. 16,17 We prefer to use hypobaric spinal anesthesia, due to difficulties of changing patient positions, advantage of decrease in urinary retention and better patient and surgeon satisfaction. During hypobaric spinal anesthesia, hypotension incidence is reduced, and recovery period shortened in our study.…”

Section: Concentration and Baricitymentioning

confidence: 99%

Should We Use Hypobaric Bupivacaine in Spinal Anesthesia for ERAS Patients Undergoing Total Hip Arthroplasty

Şahin¹,

Ay²,

Salihoğlu³

et al. 2019

Turkiye Klinikleri J Med Sci

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Enhanced Recovery After Surgery (ERAS) is a standardized perioperative care within a programme aims to reduce postoperative morbidity and length of hospital stay. The aim of this study was to evaluate which technique (hyperbaric or hypobaric spinal anesthesia) should we use in geriatric patients undergoing total hip arthroplasty according to ERAS. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 104 patients' records (52 of them hypobaric spinal, 52 of them had been applied hyperbaric spinal anesthesia), American Society of Anesthesiologists (ASA) I-III, undergoing total hip arthroplasty between June 2017-December 2017 was elected for study. Haemodynamic values, postoperative complications, hospital length of stay, readmission or reoperation after surgery, intensive care unit (ICU) length of stay, mortality, 30-day readmission two months' mortality rates, duration of surgery, gender, age, ASA and additional co-morbidities were recorded from the patients' files. R Re es su ul lt ts s: : 38 males and 66 females were involved in the study, and their mean age was 76.24 years. The hospital length of stay, readmission or reoperation after surgery, ICU length of stay, duration of surgery were statistically significant differences between the groups. There were no statistically significant differences between the groups in 30-day readmission and mortality rates. When compared the blood pressures before and after the spinal block there were statistically significant differences between the groups. C Co on nc cl lu us si io on n: : The aim of ERAS in the arthroplasty is to reduce the hospitalization time without increasing complications and readmission. We conclude that hypobaric solutions are suitable for ERAS protocol in total hip arthroplasty, but more studies should be done for evaluate effect of hypobaric spinal anesthesia related with ERAS protocol. K Ke ey yw wo or rd ds s: : ERAS; hypobaric; arthroplasty Ö ÖZ ZE ET T A Am ma aç ç: : Cerrahi Sonrası Hızlandırılmış İyileşme (ERAS), bir program dahilinde standart bir perioperatif bakım olup, postoperatif morbidite ve hastanede kalış süresini azaltmayı amaçlamaktadır. Bu çalışmanın amacı, ERAS'a göre total kalça artroplastisi uygulanan geriatrik hastalarda hangi tekniği (hiperbarik veya hipobarik spinal anestezi) kullanmamız gerektiğini değerlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmamıza Haziran 2017-Aralık 2017 tarihleri arasında total kalça artroplastisi uygulanan Amerikan Anesteziyoloji Derneği (ASA) I-III olan 104 hasta (52'sinde hipobarik spinal, 52'sinde hiperbarik spinal anestezi) kaydedildi. Hemodinamik değerler, postoperatif komplikasyonlar, hastanede kalış süresi, tekrar hastaneye yatış veya yeniden ameliyat olup olmadığı, yoğun bakım ünitesi (YBÜ) kalış süresi, mortalite, 30 gün içinde tekrar yatış, iki aylık mortalite oranları, ameliyat süresi, cinsiyet, yaş, ASA ve ek hastalıklar hastaların dosyalarından kaydedildi. B Bu ul lg gu ul la ar r: : Çalışmaya 38 erkek ve 66 kadın katıldı ve yaş ortalamaları 76,24 yıl i...

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Hypobaric Spinal Anesthesia with Ropivacaine Plus Sufentanil for Traumatic Femoral Neck Surgery in the Elderly

Cited by 15 publications

References 22 publications

Comparison of recovery effect for sufentanil and remifentanil anesthesia with TCI in laparoscopic radical resection during colorectal cancer

Comparison of recovery effect for sufentanil and remifentanil anesthesia with TCI in laparoscopic radical resection during colorectal cancer

Surgical anesthesia with a combination of T12 paravertebral block and lumbar plexus, sacral plexus block for hip replacement in ankylosing spondylitis: CARE-compliant 4 case reports

Should We Use Hypobaric Bupivacaine in Spinal Anesthesia for ERAS Patients Undergoing Total Hip Arthroplasty

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