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British Journal of Anaesthesia, 2001, Vol. 87, No. 5 738-742
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Spinal anaesthesia with 0.5% hyperbaric bupivacaine in elderly patients: effects of duration spent in the sitting position

B. T. Veering*,1, T. T. M. Immink-Speet1,2, A. G. L. Burm1, R. Stienstra1 and J. W. van Kleef1

1Department of Anaesthesiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands 2Present address: Department of Anaesthesiology, Stichting Streekziekenhuis Coevorden-Hardenberg, M. van Thijnensingel 1, 7741 GB Coevorden, The Netherlands*Corresponding author

Sixty patients, aged 65–84 yr, undergoing minor urological surgery under spinal anaesthesia remained sitting for 2 (group 1, n=15), 5 (group 2, n=15), 10 (group 3, n=15), or 20 (group 4, n=15) min after completion of the subarachnoid administration of 3 ml of a 0.5% hyperbaric bupivacaine solution. They were then placed in the supine position. Analgesia levels were assessed bilaterally using pinprick. Motor block was scored using a 12-point scale. Systolic and diastolic arterial pressures and heart rate were also recorded. Twenty minutes after the injection the upper analgesia levels were lower (P<0.05) in group 4 (median T9.0) than in the groups 1–3 (medians T6.6–T8.5). The highest obtained levels (medians T5.7–T8.0) did not differ between the groups, but occurred later (P<0.05) in group 4 (median 35 min) than in groups 1–3 (medians 19–24 min). There were no significant differences in the maximum degree of motor block or haemodynamic changes between the four study groups.

Br J Anaesth 2001; 87: 738–42


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