Ultrasound guided single injection caudal epidural anesthesia of isobaric bupivacaine with/without dexamethasone for geriatric patients undergoing total hip replacement surgery

Available online 14 February 2014

Figures & data

Table 1 Patients characteristics. Data are presented as mean (SD) for age and weight, while frequency for sex and ASA status.

Patients characteristics	Group BS (n = 36)	Group BD (n = 36)	Significance
Age (years)	71 (7)	73 (8)	0.2
Sex male/female (n)	17/19	16/20	0.8
Weight (kg)	72 (6)	75 (7)	0.08
ASA I/II status (n)	14/22	12/24	0.6

^∗P < 0.05 indicates significant difference between groups. ASA = American society of anesthesiologists, Group BS = bupivacaine and saline, and Group BD = bupivacaine and dexamethasone.

Table 2 Intraoperative data. Data are presented as mean (SD) for time to T10 sensory level, onset of complete motor block, duration of surgery, fluid intake, and blood loss, while frequency and percentage for use of ephedrine, atropine, incidence of nausea and vomiting, bradycardia, hypotension and shivering.

Intraoperative data	Group BS (n = 36)	Group BD (n = 36)	Significance
Time to T10 sensory level (min)	13 (2)	8 (2)	p < 0.0001^*
Time to onset of complete motor block (min)	21 (3)	16 (3)	p < 0.0001^*
Duration of surgery (min)	113 (8)	100 (6)	p = 0.1
Intraoperative blood loss (ml)	512 (192)	527 (204)	p = 0.8
Intraoperative fluid intake (ml)	1757 (231)	1728 (216)	P = 0.6
Use of ephedrine n (%)	5 (13.9%)	4 (11.1%)	P = 0.7
Use of atropine n (%)	4 (11.1%)	3 (8.3%)	P = 0.7
Nausea and vomiting n (%)	4 (11.1%)	3 (8.3%)	P = 0.7
Bradycardia n (%)	4 (11.1%)	3 (8.3%)	P = 0.7
Hypotension n (%)	5 (13.9%)	4 (11.1%)	P = 0.7
Shivering n(%)	4 (11.1%)	3 (8.3%)	P = 0.7

Group BS = bupivacaine and saline, and Group BD = bupivacaine and dexamethasone.

* P < 0.05 indicates significant difference between Group BD and Group BS.

Figure 1 Visual analogue scale score (VAS) at rest (median) in the two groups Postoperatively at 1, 2, 4, 6, 8, 12 and 24 h ^∗P < 0.0001 more significant in Group BD than Group BS ^°P < 0.05 more significant in Group BD than Group BS. ^°P < 0.05 more significant in Group BD than Group BS.

Figure 2 Visual analogue scale score (VAS) on movement (median) in the two groups Postoperatively at 1, 2, 4, 6, 8, 12 and 24 h postoperatively ^∗P < 0.0001 more significant in Group BD than Group BS. ^°P < 0.05 more significant in Group BD than Group BS.

Table 3 Analgesic requirement. Data are presented as mean (SD), for time to first analgesic requirement, Total dose of paracetamol analgesia and total dose of meperidine rescue analgesia.

Analgesic requirement	Group BS (n = 36)	Group BD (n = 36)	Significance
Time to first analgesic requirement (min)	213 (53)	402 (63)	P < 0.0001^*
Total dose of paracetamol analgesic requirement (mg)	3389 (728)	2833 (697)	P = 0.001^*
Total dose of meperdine rescue analgesia (mg)	142 (28)	78 (30)	P < 0.0001^*

Group BS = bupivacaine and saline, and Group BD = bupivacaine and dexamethasone.

* P < 0.05 indicates significant difference between Group BD and Group BS.