Effects of anesthesia mode on the perioperative period and postoperative outcome in patients with traumatic fractures / 解放军医学杂志

ABSTRACT

Objective To retrospectively analyze the effects of anesthesia mode on the perioperative period and postoperative outcome in patients with traumatic fractures. Methods A total of 699 patients with traumatic shoulder fractures and hip fractures, admitted in the Fourth Medical Center of PLA General Hospital from Mar. 2016 to Aug. 2018, were divided into general anesthesia (GA) group (n=331) and regional block anesthesia (RA) group (n=368) according to different anesthesia mode. The preoperative basic conditions, change rates of intra-operative mean arterial pressure (MAP) and heart rate (HR), amount of blood loss and transfusion, and postoperative outcome were recorded for analyzing whether different anesthesia methods affected the outcome of fracture patients in the real world. Results There was no significant difference in the preoperative comorbidity between the two groups (P>0.05); Compared with the GA group, patients in RA group were older (P0.05), but age analysis indicated that, regardless of the mode of anesthesia, the incidence of postoperative complications increases with age (P<0.05). Compared with GA, patients older than 80 years reduced the incidence of postoperative complications significantly when they chose RA, and the difference was statistically significant (P=0.039). Meanwhile, compared with GA group, patients in RA group was lower and shorter in preoperative time, operative time, length of stay and cost in hospital, showing statistical difference (P<0.05). Conclusions Although there was no significant difference in postoperative outcomes of patients with overall fractures under different anesthesia modes, postoperative complications will increase with age. The advantages of regional block anesthesia are mainly reflected in fracture patients ≥80 years.