Clinical effects comparison of continuous spinal, epidural and combined spinal-epidural anesthesia for arthroplasty in the elderly over 70 years / 中华老年医学杂志

ABSTRACT

Objective To compare clinical effects of continuous spinal, epidural and combined spinal-epidural anesthesia for arthroplasty in the elderly over 70 years. Methods Sixty geriatric patients, ASA status Ⅱ~Ⅲ degree, aged 71~98 yr, undergoing arthroplasty operation on hip or knee joint, were randomly assigned to group of continuous spinal anesthesia, group of combined spinal-epidural anesthesia, or group of continuous epidural anesthesia, with twenty patients of per group. T_ 10 anesthesia level was aimed by 0.5% bupivacaine titrated carefully. Results All anesthesia were clinically satisfied with average anesthesia level T_ 10(T_ 7~11). Bromage's motor blockade scale in group of continuous spinal anesthesia was higher than that in group of continuous epidural anesthesia. Amount of bupivacaine consumptions were (8.0?1.8)mg, (13.7?9.7)mg, (39.4?16.6)mg in groups of continuous spinal anesthesia, combined spinal-epidural anesthesia, and continuous epidural anesthesia respectively (P0.05). Conclusions With 0.5% bupivacaine titrated carefully, all kinds of continuous spinal, epidural and combined spinal-epidural anesthesia are clinical efficient in the elderly over 70 years for arthroplasty, of which continuous spinal anesthesia is recommended due to the most stable hemodynamics.