Spinal anaesthesia with 0.5% hyperbaric bupivacaine in elderly patients: effects of duration spent in the sitting position

Sixty patients, aged 65–84 yr, undergoing minor urologicalsurgery under spinal anaesthesia remained sitting for 2 (group1, n=15), 5 (group 2, n=15), 10 (group 3, n=15), or 20 (group4, n=15) min after completion of the subarachnoid administrationof 3 ml of a 0.5% hyperbaric bupivacaine solution. They werethen placed in the supine position. Analgesia levels were assessedbilaterally using pinprick. Motor block was scored using a 12-pointscale. Systolic and diastolic arterial pressures and heart ratewere also recorded. Twenty minutes after the injection the upperanalgesia levels were lower (P<0.05) in group 4 (median T9.0)than in the groups 1–3 (medians T6.6–T8.5). Thehighest obtained levels (medians T5.7–T8.0) did not differbetween the groups, but occurred later (P<0.05) in group4 (median 35 min) than in groups 1–3 (medians 19–24min). There were no significant differences in the maximum degreeof motor block or haemodynamic changes between the four studygroups. Br J Anaesth 2001; 87: 738–42