CONTINUOUS SPINAL ANAESTHESIA USING A STANDARD EPIDURAL SET FOR LOWER LIMB ORTHOPEDIC PROCEDURES IN HIGH RISK ELDERLY PATIENTS
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We studied 60 elderly Patients undergoing lower limb orthopedic pro cedures classified as ASA m or IV. Lumbar continuous spinal anaesthesia (CSAIwas performed using a 20C epidwal catheter through an 18 G Tuohg needle. Small local anaes thetic boluses ofisobaric bupivacaine (0.5%) was injected to achieve the desired sensory level of anaesthesia. Demographic data, anaesthetic duration, local anaesthetic doses , sen sory level to pinprick , Arterial blood pressure, heart rate, use of system ic sympathomimetics and complications were recorded. Sensory level .was between T8-T12, maximal decrease in systolic, diastollc BP and heart rate was 30+12.5%, 16.89.5% and 15.6+5.8% respectively. IV ephedrine used in 25% of our patients. While postdural puncture head ache (PDPH) occurred in 1,66% of cases. No postanaesthetic neurological deficit was recorded.We conclude that CSA using a standard epidural set and isobaric bupivacaine is feasible for L.L. surgery in high-risk elderly patients.