[The effect of spinal anesthesia on pulmonary function tests in old patients]. / Yasli hastalarda spinal anestezi uygulamasinin solunum fonksiyon testlerine etkisi.

ABSTRACT

Pulmonary function test (PFT) results are mainly dependent on age, sex, height, weight, pulmonary mechanics disturbances and cooperation of the subjects. The position and anesthesia type may also influence the PFT results. In this study we aimed to evaluate spirometric changes in old and young patients who performed spinal anesthesia. Fifty patients performed spinal anesthesia were randomized in two groups Group 1 (n= 25) aged 60-85 years old and group 2 (n= 25) aged 20-59 years old. After electrocardiography, noninvasive blood pressure and peripheral oxygen saturation (SpO2) monitorization, spinal anesthesia using 0.5% hyperbaric bupivacain from L 3-4 intervertebral space was applied. Sensory block levels, hemodynamics and PFT such as forced vital capacity (FVC), forced expiratory volume/1 second (FEV(1)), peak expiratory flow (PEF), and forced expiratory flow at the 25 and 75% of the pulmonary volume (FEF(25-75)) were performed before and after spinal anesthesia in 10th, 40th and 100th minutes in supine and 30 degrees head position using hand type spirometry. Wilcoxon paired two tests statistical analysis was used to compare PFT changes of the subjects. Mean arterial blood pressure levels and spirometric measurements of FVC, FEV(1) and FEF25-75 decrease with respect to basal values in 40th minutes was significant in old patients whom spinal anesthesia was over Th6 level but in young patients the changes were not significant. PFT decrement probabilities should be taken in account in old patients supposing for spinal anesthesia and be paid attention for high level spinal blocks in risk group patients.