Retrospective evaluation of general and spinal anesthesia during urological surgery in patients aged 65 years or older
Tansu Gökay Tarhan1, Canan Tülay Işıl2, Sibel Oba2, Hale Dobrucalı2, Hacer Şebnem Türk2, Pınar Sayın2, Yaşar Söğüt2, Ayşe Hancı2
1Van Bölge Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Van, Türkiye
2Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye
Keywords: General anesthesia; geriatrics; spinal anesthesia.
Objectives: This study aims to evaluate the hemodynamical differences, postoperative intensive care requirements and mortality rates of urology patients aged 65 years or older who underwent surgery with general anesthesia and spinal anesthesia.
Materials and methods: In this retrospective study, we examined 2,053 patients aged 65 years or older, who had urogenital operation at the urology clinic of Şişli Hamidiye Etfal Training and Research Hospital between 01.08.2012 and 01.08.2013. Patients’ data were collected from follow-up records prepared by anesthesiology and urology clinics. As a result of the analysis, we included 264 patients in the study who were divided into two groups according to the type of performed anesthesia as general anesthesia (group G, n=74) and spinal anesthesia (group S, n=190). We recorded demographic data such as age, gender, diagnosis, comorbidity, drug usage, preoperative laboratory results; duration of anesthesia and surgery, perioperative total fluid transfusion and use of blood products. Systolic and diastolic blood pressure, heart rate (HR) and blood oxygen saturation (SpO2) values were recorded at the beginning (0), at the 10th, 30th, 60th minutes and at the end of the operation. Perioperative and postoperative adverse effects or compli- cations due to anesthetic procedures, postoperative intensive care unit requirements and mortality frequency were also recorded.
Results: Anesthesia and operation duration was longer in group G (p=0.003, p=0.000, respectively), HR was lower at the 60th minute and at the end of the operation (p=0.011, p=0.023, respectively). In group S, a decrease in SPO2 value was detected at the 10th, 30th, 60th minutes and at the end of the operation (p<0.05). There was no significant difference found in complication rates, mortality rates, postoperative intensive care unit requirements and hospitalization rates in intensive care unit.
Conclusion: Hereby, hemodynamical differences between spinal anesthesia and general anesthesia were observed in the retrospective analysis of patients aged 65 years or older who underwent urological surgery.