Spinal anesthesia does not cause left ventricular dysfunction in patients older than 60 years without cardiovascular...

Area of Science:

• Anesthesiology
• Cardiology
• Geriatric Medicine

Background:

• Elderly patients are increasingly undergoing surgical procedures.
• Spinal anesthesia is a potential option for this population due to its known effects on sympathetic blockade and vasodilation.
• Previous studies have not evaluated the impact of spinal anesthesia on left ventricular systolic function in older adults.

Purpose of the Study:

• To assess left ventricular systolic function using transthoracic echocardiography in patients over 60 years old.
• To evaluate the effects of spinal anesthesia on cardiac function in elderly patients without pre-existing cardiovascular disease.

Main Methods:

• Prospective observational study involving 54 patients aged over 60 without prior cardiovascular disease.
• Spinal anesthesia administered using hyperbaric 0.5% bupivacaine, targeting a sensory block at or above T10.
• Left ventricular systolic function assessed via MAPSE, CI-IVC, LVOT-VTI, and CO measurements before and 5 minutes after anesthesia.

Main Results:

• A minor, statistically insignificant decrease in MAPSE (3.3%) and LVOT-VTI and CO was observed.
• No significant clinical or statistical differences in echocardiographic changes were found between hypotensive and non-hypotensive patients.
• A small percentage (14.8%) of patients experienced mean arterial pressure (MAP) below 60 mmHg.

Conclusions:

• Spinal anesthesia, with a sensory block at T10 or higher, is a safe anesthetic technique for elderly patients without cardiovascular disease.
• The procedure does not significantly alter echocardiographic parameters of left ventricular systolic function in this patient group.