EFFECT OF EPIDURAL ANAESTHESIA AND INTRATHECAL MORPHINE ANALGESIA ON POSTOPERATIVE MYOCARDIAL ISCHEMIC CHANGES IN ELDERLY PATIENTS UNDERGOING REPAIR OF FRACTURE AROUND THE HIP

Abstract

This study was done in Assiut University Hospital, Faculty of Medicine, Anaethesia Department. All patients gave informed consents and the study protocol was approved by the hospital ethical committee.

The aim of this study is to study the effect of intrathecal morphine analgesia (optimization of analgesia) on the incidence of silent myocardial ischemia, that it reduce the incidence of SMI with favorable alteration on characteristics of ischemic episodes and as well as cardiac outcome.

One hundred patients scheduled in prospective cohort blinded observer

study for elderly age group patients (above 60 years) who undergoing

surgery around the hip. Patients were of both sexes (68 males and 32 females), all patients had free preoperative ECG as inclusion criteria, • however, the exclusion criteria included; contraindication to regional anesthesia, ECG abnormality, valvular lesion or under digoxin treatment.

Induction of anaesthesia with pre-empetive analgesia were done by small dose epidural anaesthesia plus insertion of epidural catheter and intrathecal morphine analgesia (0.05 mg) were carried out using combined spinal epidural (CSE) technique, full intraoperative monitoring was done and the hemodynamic data were recorded every 10 min. in the first hour and every 15 min. after that.