Background: Hypoxemia caused high altitude leads to an increase and variability in CSF volume. The purpose of\nthis prospective study was to detect the differences, if any, between moderately highlanders and lowlanders in\nterms of anaesthetic parameters under neuroaxial anaesthesia.\nMethods: Consecutive patients living at moderately high altitude (Erzurum, 1890 m above the sea level) and sea\nlevel (Sakarya, 31 m above the sea level) scheduled for elective lower extremity surgery with spinal anaesthesia\nwere enrolled in this study (n = 70, for each group). Same anaesthesia protocol was applied for all patients. Spinal\nanaesthesia was provided with hyperbaric bupivacaine 0.5 %, 9 mg (1.8 mL) in all patients. Anaesthetic\ncharacteristics and hemodynamic parameters of patients were recorded. The findings obtained in two different\naltitudes were compared using appropriate statistical tests. If data was not normally distributed, comparisons were\ndetermined using the Mannââ?¬â??Whitney U-test. Comparisons were determined using the Independent T test when\ndata was normally distributed and Fisherââ?¬â?¢s exact test was used to compare the percentage values.\nResults: Duration of the block procedure (minutes) was significantly shorter at the sea level (14.34 Ã?± 0.88) than at\nmoderate altitude (20.38 Ã?± 1.46) (P < 0.001). Motor block duration (minutes) was higher at the sea level compared to\nthe moderate altitude (310.2 Ã?± 104.2, 200.4 Ã?± 103.2; respectively; P < 0.05). Also, the sensory block time (minutes) was\nhigher at the sea level compared to moderate altitude (200.2 Ã?± 50. minutes vs. 155.2 Ã?± 60.7 min; respectively;\nP < 0.05). Moderate altitude group had significantly higher MABP values at baseline, during surgery and at\npostoperative 1st and 2nd hours than in the sea level group (P < 0.05, for all). Moderately high altitude group had\nlower heart rate values at baseline, during surgery and postoperative 1st and 2nd hours compared with the sea level\ngroup (P < 0.05). PDPH was seen more frequently (7.14 vs. 2.85 %; P < 0.05) at moderate altitude.\nConclusions: Hemodynamic variations and more anaesthetic requirements following the spinal anaesthesia may be\nobserved at moderately high altitudes compared to the sea level.
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