A Comparative Randomized Control Study of Continuous Spinal Anaesthesia with Continuous Epidural Anaesthesia in Elderly Patients Undergoing Dynamic Hip Screw Surgeries

Abstract

Background: Hip fractures in elderly patients is common and occurs with trivial fall. Continuous epidural anesthesia (CEA) and Continuous spinal anesthesia (CSA) are available modalities for lower extremities surgeries. This study was done to compare the effectiveness of CEA and CSA. Methods: A prospective open-label randomized control trial was carried out in the Department of Anaesthesiology and Critical care at GMC, Kadapa, from January 2019 to July 2020. One hundred patients were enrolled and divided into Group A and B, with 50 participants in each group. Group A received continuous spinal anesthesia, and Group B was given continuous epidural anesthesia. VAS score, Onset of sensory block, the Onset of motor block and no. of rescue analgesia, etc., were considered as the primary outcome variable. coGuide statistical software was used for analysis. Results: There was a statistically significant difference between the study groups (Group A vs. Group B) in the Onset of sensory block (7.6 ± 1.6 min, 17.5 ± 1.62 min), the start of motor block (10.1 ± 1.11 min,20.28 ± 1.36 min), duration of sensory block (108.7 ± 16.84 min, 147.4 ± 20.39 min), duration of motor block (175.8 ± 12.47 min, 219.4 ± 18.56 min) and analgesia duration (199.2 ± 11.92 min, 327.6 ± 18.8 min) respectively. The Difference in the number of rescue analgesia in 24 hrs between the study group was significant with a P-value of <0.001. Conclusion: The current study revealed that CSA is more effective than CEA in Hip surgeries.

Keywords

• Continuous epidural anesthesia
• Continuous spinal anesthesia
• dynamic hip screw
• elderly patients
• Fentanyl
• Ropivacaine.