Influence Of Low Dose Intrathecal Naloxone On Bupivacaine - Fentanyl Spinal Anaesthesia For Lower Limb Orthopedic Surgery In Elderly Patients

• Status: Completed
• Trial end date: 2021-03-10
• Target enrollment: 0
• Participant gender: All

Summary

Fentanyl is a safer alternative than morphine in the management of postoperative pain in elderly. However, pruritus, nausea and vomiting are unwanted side effects of intrathecal fentanyl administration, that can decrease patient satisfaction with anaesthesia, delay post anaesthesia care unit ( PACU ) discharge, and increase costs.

The incidence of pruritus with neuraxial fentanyl is high. The incidence of pruritus in non-obstetric surgery patients after intrathecal fentanyl ranges from 53% to 79%.

Naloxone hydrochloride is a pure opioid competitive antagonist. Small doses of naloxone may reduce Fentanyl-associated adverse effects, such as pruritus, nausea and vomiting without affecting analgesia.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Kasr El Aini Hospital
• Collaborator: Mansoura University
• Treatments: Bupivacaine; Fentanyl; Naloxone

Criteria

Inclusion Criteria:

• Age ≥ 60y of either gender.

• ASA physical status III or below.

• Patients scheduled for elective unilateral lower limb orthopedic surgery.

Exclusion Criteria:

• Morbid obese patients.

• Severe or uncompensated cardiovascular, renal, hepatic or endocrinal diseases.

• Allergy to one of the agents used.

• Severely altered consciousness level.

• Coagulopathy

• Increased intracranial pressure

• Neuromuscular diseases

• Severe spinal deformity

• Patients on opioid analgesics or opioid abuse

• Multi traumatized patients

• Patients with preoperative Mini Mental State Examination ( MMSE ) scoring < 24