Combined spinal and epidural anaesthesia in elderly patients.

The study was designed to investigate the effects of simultaneously combined spinal-epidural anaesthesia in elderly patients and to evaluate the problems encountered during and after performing spinal block following epidural blockade. Nineteen ASA grade III elderly patients (mean age 75.8 years) were included in the study. The first 10 patients (group 1) were given 0.5% hyperbaric bupivacaine 2 ml (10 mg) and fentanyl 0.25 ml (12.5 microg) intrathecally. The remaining nine patients (group 2) received 0.5% hyperbaric bupivacaine 1 ml (5 mg) intrathecally; following the spinal block fixation (about 15 min), fentanyl 1 ml (50 microg) in saline 10 ml was injected into the epidural catheter. The highest sensory block was achieved at T6 and T9 in groups 1 and 2, respectively. None of the patients experienced respiratory depression, sedation, vomiting, shivering or headache. In conclusion, simultaneous combination of subarachnoid and epidural blockade may provide sufficient anaesthesia with fewer complications.