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Acta clinica Croatica, Vol. 58. No. Supplement 1, 2019.

Original scientific paper

https://doi.org/10.20471/acc.2019.58.s1.01

Dexamethasone - Intrathecal Minimiser of Simple Haemathologic Stress Biomarkers in Hip Fracture

Livija Šakić orcid id orcid.org/0000-0001-8906-3558 ; Department of Anaesthesiology, Reanimatology and Intensive Medicine, University Hospital “Sveti Duh”, Zagreb, Croatia
Dinko Tonković ; Department of Anaesthesiology, Reanimatology and Intensive Therapy, University Hospital Centre Zagreb “Rebro”, School of Medicine, University of Zagreb, Zagreb, Croatia
Kata Šakić ; Department of Anaesthesiology and Pain Therapy at Maxillofacial, General and Plastic surgery Polyclinic “Bagatin”, Zagreb, Croatia

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Abstract

Proximal femoral fractures are the most common cause of emergency admission to hospital with high postoperative morbidity. The hypothesis was that a single shot of intrathecal dexamethasone and levobupivacaine in anaesthesia for surgical correction of proximal femoral fracture in elderly patients reduces surgical stress with better quality hospitalisation. The study included sixty elderly patients with proximal femoral fracture, ASA status 2 and 3, randomised into two groups. The study group of thirty patients received 8 mg of dexamethasone and 12,5 mg of levobupivacaine 0,5 % intrathecally, DLSA group, and the parallel group of thirty patients received
12,5 mg of levobupivacaine 0,5 % intrathecally, LSA group. Plasma cortisol and glucose concentrations were assessed before and after anaesthesia, pain intensity was evaluated using Visual Analogue Scale score and hospitalisation was analysed. Results showed decreased cortisol concentrations, longer analgesia duration and shorter hospitalisation in the DLSA group. Glucose concentrations did not differ significantly between the patients in either group. Enlightening the study results collected, single shot of intrathecal administration of dexamethasone in spinal anaesthesia for surgical treatment of proximal femoral fractures reduces the stress response by decreasing plasma cortisol concentrations prolonging analgesia with better rehabilitation possibilities, hence shortening hospitalisation which explains this pattern of anaesthesia.

Keywords

cortisol; glucose; stress; pain; spinal anaesthesia; femoral fracture; hospitalization

Hrčak ID:

224142

URI

https://hrcak.srce.hr/224142

Publication date:

1.7.2019.

Article data in other languages: croatian

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