Implant fixation repairs lower extremity fractures in the elderly：effects of different anesthesia methods on hemodynamics and analgesia / 中国组织工程研究

ABSTRACT

BACKGROUND:The medication of spinal-epidural anesthesia does not have great differences as compared with spinal anesthesia and epidural anesthesia alone. That is, a large-dose spinal anesthesia is first used. Epidural anesthesia is utilized to ensure effects and postoperative analgesia. Recent scholars proposed some new ideas smal-dose and low-concentration local spinal anesthetics are first used, and smal-dose and low-concentration local epidural anesthetics are then utilized, which realy plays a joint role in spinal and epidural anesthesia, and achieves perfect anesthesia outcomes, and reduces adverse reactions and complications. OBJECTIVE:To analyze application outcomes of smal-dose and low-density local spinal-epidural anesthesia to repair surgery of elderly lower limb fractures. METHODS:A total of 68 cases, who would receive the surgery of unilateral lower limb in the Huizhou Central People’s Hospital, were selected in this study. They were equaly assigned to control group and observation group according to the anesthesia manner. Each group contained 34 cases. Control group received continuous epidural anesthesia. Observation group received smal-dose and low-density local spinal-epidural anesthesia. Onset time of anesthesia, blocking perfect time, the amount of narcotic drugs, lower limbs modified Bromage score and hemodynamic alterations were compared and analyzed between two groups. RESULTS AND CONCLUSION:Onset time of anesthesia, blocking perfect time, the amount of narcotic drugs, and lower limbs modified Bromage score were better in the observation group than in the control group (P < 0.05). Mean arterial pressure was significantly lower at 5 and 10 minutes after anesthesia than that before anesthesia in both groups (P < 0.05). No significant difference was detected in other indexes. Patients from the two groups had stable vital signs. No postoperative cognitive dysfunction occurred. These data indicated that smal-dose and low-density local spinal-epidural anesthesia was characterized by rapid onset, less dose, complete block and good analgesia. It is used in the repair surgery of lower extremity fractures in elderly, and has little effect on hemodynamics in patients, and can achieve a more perfect analgesia.