[Spinal anesthesia with various anesthetic agents due to endoscopic urological procedure in patient over 60 years old].

Aim of the study is to compare efficiency and safety of method of spinal anesthesia with isobaric bypivacain (5 mg/ml) and ropivacain 5 (mg/ml) during performing transurethral resection of the prostate in patients over 60 years old. Methods 38 patients (68-82 years old ASAII-ASAIII) with hyperplasia of prostate gland were examined in randomized clinical study. Two methods of anesthetic management were compared. In first group of 19 patients was administrated intrathecal with isobaric bypivacain (5mg/ml), second group of 19 patients were administrated with ropivacain (5mg/ml). The efficiency of spinal anesthesia was estimated. Monitoring: Harvard standard of monitoring, ectodermic activity, characteristic of heart rhythm, medical audit. All patients in both groups were same age, physical status, anthropometric information, had equal duration of surgery and dose of local anesthetic agent (15mg). However difference between efficiency of spinal anesthesia was discovered. In group with bypivacain sensory block developed in 1.35 times faster it lasted on 1.22 time longer and motor block developed in 1.4 times faster with a longer duration in 1.32 times than group with ropivacain. Hemodynamic and condition of vegetatic homeostasis in both groups were almost equal but analyzed data presented that ropivacain (5 mg/ml) influenced hemodynamic less. Results of retrospective study demonstrates that it is safer to use isobaric ropivacain (5 ml/mg) in elderly patients for spinal anesthesia in 1.5 times p = 0,007). In conclusion spinal anesthesia with isobaric bypivacain (5mg/ml) more efficient because of duration and time of development of neuroaxial block on the other hand isobaric ropivacain 5 mg/ml is safer to use in patients older than 60 years old.