Should we use hypobaric bupivacaine in spinal anesthesia for ERAS patients undergoing total hip arthroplasty [ERAS protokolüile total kalça protezi yapilan hastalarda hipobarik bupivakain ile spinal anestezi uygulamali miyiz?]

Abstract

Objective: 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. Material and Methods: 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. Results: 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. Conclusion: 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. © 2019 by Türkiye Klinikleri.