ABSTRACT
Objective To retrospectively analyze the effects of nerve block anesthesia versus general anesthesia on intertrochanteric fracture in the elderly. Methods The 104 elderly inpatients undergoing closed reduction and intramedullary nailing for the treatment of femoral intertrochanteric fractures were recruited into this study at Department of Orthopedics ,Xiangya Hospital ,Central South University from January 2015 to June 2017.Medical records were collected and analyzed by SPSS 16.0 or GraphPad Prism 6.0 software. Results A total of 104 patients were divided into general anesthesia group(n= 48 )and nerve block anesthesia group (n= 56 ). There was no statistical difference in the demographic characteristics between the two groups. The changes in heart rate ,maximum changes of systolic/diastolic blood pressures ,and infusion volume during surgery were lower in the nerve block anesthesia group than in the general anesthesia group [(12.7 ± 7.3)vs. (18.1 ± 7.8)beats/min ,(22.5 ± 8.8/12.2 ± 7.5)mmHg vs. (34.3 ± 7.9/21.6 ± 6.6)mmHg ,(792.9 ± 387.0)ml vs. (1 083.0 ± 445.5)ml ,respectively ,t=3.64 ,7.14 ,6.73 ,5.16 ,all P＜0.01]. There was no statistically significant difference between two groups in other perioperative data and the number of deaths at three months and one year after surgery. Conclusions As compared with the general anesthesia ,the nerve block anesthesia has less effects on the heart rate ,less maximum changes of systolic and diastolic blood pressures ,and less infusion volume during surgery ,and has no significant increase in postoperative mortality ,which is safe and worthy of further promotion.
ABSTRACT
OBJECTIVE:To provide the clinical departments with a reference for promoting rational drug use. METHODS:The inpatient prescriptions given by orthopaedics and burn departments from Jun. to Dec. 2013 were selected randomly. The number of the selected prescriptions by each department accounted for 2% of the total prescriptions given by the corresponding department in that month,including 4 921 cases by orthopaedics department and 1 391 cases by burn department. Statistical analysis of irrational prescriptions was made according to Chinese Pharmacopoeia,New Materia Medica,the package insert, and other relevant references. RESULTS:1 821 prescriptions given by orthopaedics department and 378 by burn department were found to be irrational,accounting for 37.00% and 27.17% respectively. The reasons of irrationality mainly included im-proper compatibility,improper route of administration,contraindication in and use with caution by the elderly and children,re-peated drug use,improper drug combination etc. CONCLUSIONS:The system of prescription review should be strengthened, and clinical staff training system and pharmaceatical knowledge information platform are established to promote rational use of drugs.