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Comparison of continuous spinal and continuous epidural anaesthesia for lower limb surgery in elderly patients. A
P A Sutter1, Z Gamulin, A Forster
1Department of Anaesthesiology, University Hospital of Geneva, Switzerland.
Abstract:
This retrospective study compared continuous spinal anaesthesia with continuous epidural anaesthesia for lower limb orthopaedic surgery in the elderly. The anaesthetic records of 457 patients who received continuous spinal anaesthesia and 274 who received continuous epidural anaesthesia over a 5-year period were analysed. The patients who had continuous spinal anaesthesia were at a higher anaesthetic risk (ASA 3-4, 76% as compared with 37%, p less than 0.001), but the incidence of failures was significantly lower (1.7%, as compared with 9%, p less than 0.001) and fewer patients showed a decrease in mean arterial pressure of more than 30% (44%, as compared with 65%, p less than 0.001) and (or) received vasopressors (65%, as compared with 77%, p less than 0.01). Our data show continuous spinal anaesthesia to be more reliable and to provide better cardiovascular stability.