Comparison of Low-Dose Versus Standard-Dose Hyperbaric Bupivacaine in Spinal Anesthesia
10. juli 2026 opdateret af: Muhammad Shaheryar Bashir, Mayo Hospital Lahore
Comparison of Low-Dose Versus Standard-Dose Hyperbaric Bupivacaine in Spinal Anesthesia: Hemodynamic Stability and Recovery Profile in Elderly Patients Undergoing Lower Limb Orthopedic Surgery
The goal of this randomized controlled trial is to determine whether low-dose hyperbaric bupivacaine provides better hemodynamic stability and postoperative recovery compared with standard-dose hyperbaric bupivacaine in elderly patients undergoing lower limb orthopedic surgery under spinal anesthesia.
The main questions it aims to answer are:
- Does low-dose hyperbaric bupivacaine reduce the incidence of intraoperative hypotension and bradycardia compared with standard-dose hyperbaric bupivacaine?
- Does low-dose hyperbaric bupivacaine improve postoperative recovery profile compared with standard-dose hyperbaric bupivacaine?
Researchers will compare elderly patients receiving low-dose hyperbaric bupivacaine with those receiving standard-dose hyperbaric bupivacaine to determine whether a lower intrathecal dose improves cardiovascular stability and recovery without compromising the effectiveness of spinal anesthesia.
Participants will:
- Provide written informed consent before enrollment.
- Undergo elective lower limb orthopedic surgery under spinal anesthesia.
- Be randomly assigned to receive either low-dose or standard-dose hyperbaric bupivacaine.
- Have their blood pressure, heart rate, and other vital signs monitored throughout the surgical procedure.
- Be assessed for intraoperative hypotension and bradycardia according to predefined study criteria.
- Be evaluated for postoperative recovery parameters, including motor recovery and readiness for postoperative recovery and mobilization.
The information obtained from this study may help identify a safer and more effective spinal anesthetic technique for elderly patients undergoing orthopedic surgery.
Studieoversigt
Status
Ikke rekrutterer endnu
Betingelser
Intervention / Behandling
Undersøgelsestype
Interventionel
Tilmelding (Anslået)
180
Fase
- Fase 4
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiekontakt
- Navn: Muhammad Shaheryar Bashir, MBBS, BSc, FCPS (R) CHPE, DPHN
- Telefonnummer: +92-335-4377900
- E-mail: drmsb259@gmail.com
Studiesteder
-
-
Punjab Province
-
Lahore, Punjab Province, Pakistan, 54950
- Mayo Hospital, Lahore
-
-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
- Ældre voksen
Tager imod sunde frivillige
Ingen
Beskrivelse
Inclusion Criteria:
- Male or female patients aged 65 years and above.
- Patients scheduled for elective lower limb orthopedic surgery under spinal anesthesia.
- American Society of Anesthesiologists (ASA) physical status I-III.
- Patients willing to participate and provide written informed consent.
Exclusion Criteria:
- Refusal to participate in the study.
- Contraindications to spinal anesthesia (e.g., infection at puncture site, coagulopathy, severe hypovolemia, raised intracranial pressure).
- Known hypersensitivity or allergy to bupivacaine.
- Severe valvular heart disease.
- Significant cardiac arrhythmias.
- Uncontrolled hypertension.
- Severe hepatic or renal impairment.
- Pre-existing neurological disorders affecting lower limb motor or sensory function.
- Severe spinal deformity or previous lumbar spine surgery interfering with spinal anesthesia.
- Cognitive impairment or inability to provide informed consent.
- Emergency orthopedic procedures.
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Low-Dose Hyperbaric Bupivacaine
Participants randomized to this group will receive low-dose hyperbaric bupivacaine for spinal anesthesia before elective lower limb orthopedic surgery.
Hemodynamic parameters and postoperative recovery outcomes will be assessed according to the study protocol.
|
Low-dose hyperbaric bupivacaine administered intrathecally for spinal anesthesia in elderly patients undergoing elective lower limb orthopedic surgery.
|
|
Aktiv komparator: Standard-Dose Hyperbaric Bupivacaine
Participants randomized to this group will receive standard-dose hyperbaric bupivacaine for spinal anesthesia before elective lower limb orthopedic surgery.
Hemodynamic parameters and postoperative recovery outcomes will be assessed according to the study protocol.
|
Standard-dose hyperbaric bupivacaine administered intrathecally for spinal anesthesia in elderly patients undergoing elective lower limb orthopedic surgery.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence of Intraoperative Hypotension
Tidsramme: From administration of spinal anesthesia until completion of surgery
|
Occurrence of intraoperative hypotension following spinal anesthesia, defined as a decrease in systolic blood pressure greater than 20% from baseline or systolic blood pressure less than 90 mmHg requiring intervention.
|
From administration of spinal anesthesia until completion of surgery
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence of Intraoperative Bradycardia
Tidsramme: From administration of spinal anesthesia until completion of surgery.
|
Occurrence of intraoperative bradycardia, defined as heart rate less than 50 beats per minute requiring pharmacological treatment.
|
From administration of spinal anesthesia until completion of surgery.
|
|
Time to Complete Motor Recovery
Tidsramme: From completion of surgery until achievement of Bromage Score 0, assessed up to 24 hours postoperatively
|
Time required to achieve complete motor recovery following spinal anesthesia, assessed using Bromage Score 0.
|
From completion of surgery until achievement of Bromage Score 0, assessed up to 24 hours postoperatively
|
|
Time to First Ambulation
Tidsramme: Within the first 24 hours after surgery
|
Time from completion of surgery to the patient's first assisted ambulation.
|
Within the first 24 hours after surgery
|
|
Postoperative Recovery Profile
Tidsramme: From completion of surgery until discharge from the post-anesthesia care unit (PACU), assessed up to 24 hours postoperatively
|
Assessment of recovery following spinal anesthesia, including readiness for discharge from the post-anesthesia care unit and return of motor function.
|
From completion of surgery until discharge from the post-anesthesia care unit (PACU), assessed up to 24 hours postoperatively
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Lee YY, Ngan Kee WD, Muchhal K, Chan CK. Clinical comparison of 12 mg ropivacaine and 8 mg bupivacaine (with fentanyl) in spinal anaesthesia for major orthopaedic surgery in geriatric patients. Acta Anaesthesiol Scand. 2011;55(3):298-303
- Ben-David B, Frankel R, Arzumonov T, Marchevsky Y, Volpin G. Minidose bupivacaine-fentanyl spinal anesthesia for surgical repair of hip fracture in the aged. Anesthesiology. 2000 Jan;92(1):6-10. doi: 10.1097/00000542-200001000-00007.
- Patel A, Yadav AK, Patel PS, Kumari R, Deepesh. Comparative hemodynamic stability in low-dose versus conventional-dose bupivacaine for spinal anaesthesia in elderly patients. Int J Pharm Res Technol. 2025;15(2). doi:10.31838/ijprt/15.2.89.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Anslået)
1. juli 2026
Primær færdiggørelse (Anslået)
30. juni 2027
Studieafslutning (Anslået)
30. juni 2027
Datoer for studieregistrering
Først indsendt
24. juni 2026
Først indsendt, der opfyldte QC-kriterier
29. juni 2026
Først opslået (Faktiske)
6. juli 2026
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
13. juli 2026
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
10. juli 2026
Sidst verificeret
1. juli 2026
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Andre undersøgelses-id-numre
- Mayo_ANS_01
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
INGEN
IPD-planbeskrivelse
Individual participant data (IPD) collected during this study will not be made publicly available.
Participant confidentiality and privacy will be maintained in accordance with institutional ethical guidelines and the approved study protocol.
Aggregate study results may be published or presented, but individual-level data will not be shared outside the research team.
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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