engleski

EARLY DATA IN INFLUENCE OF DEXAMETHASONE ADMINISTRATION IN SPINAL ANESTHESIA FOR FEMUR FRACTURE

Background and aims: The aim of this research is to establish the influence of intrathecal dexamethasone administration in spinal anesthesia with levobupivacaine on postoperative pain, consciousness and values of cortisol levels for patients with femur fracture. Methods: The study is planned as a prospective, interventional, randomized clinical trial. A total of 60 patients ASA2 and ASA3 status, scheduled for surgical procedures will be sorted into two groups and undergo surgery in spinal anesthesia with 12, 5mg of levobupivacaine (SA) group and with addition 8mg of dexamethasone (DSA) group. The primary outcome measure is the occurrence of postoperative disturbance of consciousness and plasma cortisol levels. As a secondary outcome measure, we are following pain intensity, blood glucose levels and recovery. Cortisol and glucose are analyzed in five measurements. Peripheral venous blood samples are collected before anesthesia, one hour after surgery, third, fifth and on the tenth day after surgery. Postoperative delirium is defined by using Confusion Assessment Method (CAM) criteria. Visual analogue scale (VAS) is used to record pain severity among patients. Results: We collected data for 16 patients so far. Postoperative cortisol plasma levels in 8 patients in DSAgroupwere significantly lower 210(184-262) nmol/L in comparison to 8 patients in SA group with postoperative cortisol plasma levels 713(354-794) nmol/L. The duration of analgesia in DSA group was 428±72.57minutes and in SA group 212±34.76 minutes. According to CAM criteria postoperative cognitive disturbances were seen in 5(31%) patients in SA group. Conclusions: The addition of dexamethasone to the local anesthetic significantly prolongs the duration of sensory block and decreases opioid requirements and postoperative cognitive disturbances.

intrathecal dexamethasone ; spinal anaesthesia ; cortisol ; femur fracture ; pain ; cognitive disturbances

nije evidentirano