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Spinal Hypobaric Local Anesthetic Study

Anesthesia, Local

The length of hospital stay after total hip and knee arthroplasty is determined based on the successful mobilization of the patients post surgery. Fast track pathways involving early mobilization and discharge of the patient on the same day of surgery, shortens the hospital stay and reduces the risk of adverse effects. The long acting LA (bupivacaine) is most commonly used in spinal anesthesia for arthroplasty surgeries and is associated with a prolonged motor and sensory block. In contrast, hypobaric bupivacaine and hypobaric mepivacaine helps in achieving the desired block level with smaller dosage and shorter onset time and faster recovery when compared to long acting local anesthetics. The aim of the study is to observe the effects of hypobaric local anesthetics ( bupivacaine and mepivacaine ) in patients undergoing unilateral total hip or knee arthroplasty in terms of time to onset and time to recovery of the block and also its effect on hemodynamic stability and time to mobilization after surgery. This study will allow the investigators to recommend optimal dosing strategies that in turn will help in faster recovery from spinal anesthesia and early mobilization thereby reducing harmful outcomes.

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Participation Requirements

  • Sex:

    ALL

  • Eligible Ages:

    20 and up

Participation Criteria

Inclusion Criteria:

1. Patients undergoing elective unilateral total hip or knee arthroplasty under spinal anesthesia at Toronto Western Hospital
2. American Society of Anesthesiologists physical status class (ASA-PS) 1-3
3. Aged ≥ 20 years

Exclusion Criteria:

1. Refusal to participate
2. Inability to communicate due to language barrier or cognitive impairment
3. Height \< 150 cm or \> 200 cm
4. Weight \< 40 kg or \>130 kg
5. Contraindication or allergy to amide-type local anesthetic
6. Contraindication to spinal anesthesia (e.g., infection at the injection site, existing coagulopathy)
7. Spinal anesthesia performed in the operating room rather than the block room (which will preclude adequate testing)
8. Spinal anesthesia that includes administration of intrathecal opioids (e.g., morphine, fentanyl),so as to avoid unanticipated alterations in block quality or solution baricities.
9. Pre-existing sensory or motor impairment in the lower extremities

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Study Location

Toronto Western Hospital
Toronto Western Hospital
Toronto, Ontario
Canada

Contact Study Team

Primary Contact

Jayanta Chowdhury

[email protected]
416-603-5800
Study Sponsored By
University Health Network, Toronto
Participants Required
More Information
Study ID: NCT06166394