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The Performance of Spinal Anesthesia Is Marginally More Difficult in the Elderly
  1. Michael J. Tessler, M.D.,
  2. Ken Kardash, M.D.,
  3. Richard M. Wahba, M.D.,
  4. Simcha J. Kleiman, M.D.,
  5. Stamatina T. Trihas, R.R.T. and
  6. Michel Rossignol, M.D.
  1. From the Department of Anaesthesia and Epidemiology, The Sir Mortimer B. Davis-Jewish General Hospital, and McGill University, Montreal, Quebec, Canada.
  1. Reprint requests: Michael J. Tessler, M.D., Department of Anaesthesia, Rm A-335, Sir Mortimer B. Davis-Jewish General Hospital, 3755 Cote Ste. Catherine Road, Montreal, Quebec, Canada, H3T 1E2.


Background and Objectives. We sought to determine if spinal anesthesia is more difficult to perform in the elderly.

Methods. All spinal anesthetics administered over 18 months by 18 anesthesiologists were eligible. We excluded anesthetics for hip fractures and cesarean deliveries. We recorded time to completion, number of spinal needles used, and number of approaches. The patients were prospectively divided into three age categories: patients <50 years of age (group 1); 50-70 years of age (group 2); and >70 years of age (group 3). Descriptive statistics and chi-square test were performed.

Results. Nine hundred and ninety-nine anesthetics were analyzed. There were 368, 336, and 295 entries in groups 1, 2, and 3, respectively. Although the mean ± SD (in min) times to accomplish the spinal technique were not significantly different (4.3 ± 4.1, 4.4 ± 3.2, and 4.6 ± 3.4 for groups 1, 2, and 3), there was a statistically greater frequency of more than one spinal needle used and more than one approach needed in the elderly.

Conclusions. We conclude that patient age is a minor independent predictor of increased technical difficulty with spinal anesthesia.

  • spinal anesthesia
  • geriatrics
  • anesthetic techniques
  • elderly.

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  • This study was presented in part at the 53rd Annual Meeting of the Canadian Anaesthetists' Society in Montreal, Canada, June 1996.