Effect of epidural anesthesia combined with general anesthesia on the expression of serum IL-6,IL-8 and CRP in patients undergoing hip replacement / 中国基层医药

ABSTRACT

Objective To investigate the clinical effect of epidural anesthesia combined with general anesthesia on the expression of serum interleukin 6(IL-6),interleukin 8(IL-8) and C-reactive protein (CRP) in patients undergoing hip replacement.Methods From February 2017 to February 2018,82 patients who underwent hip replacement in Zhuji People's Hospital were selected in the research.According to the random table method ,the patients were divided into two groups , with 41 patients in each group.The observation group was given epidural anesthesia combined with general anesthesia ,while the control group was given general anesthesia.The extubation time and recovery time,the scores of MMSE and the changes of inflammatory factors at preoperation ,postoperative 3h and postoperative 24h were compared between the two groups.Results The extubation time and recovery time of the observation group [( 10.93 ±2.41) min and (17.85 ±3.24) min] were shorter than those of the control group [(16.29 ±2.73)min and (23.94 ±2.46)min] (t＝9.425,9.586,all P＜0.05).The scores of MMSE in the obser-vation group at postoperative 3h[(25.48 ±1.43)points] and postoperative 24h [(26.83 ±1.09)points] were higher than those in the control group [(23.09 ±1.60) poinrts and (25.32 ±1.42) points] ( t＝7.132,5.401,all P＜0.05).The serum levels of IL-6,IL-8 and CRP in the observation group at postoperative 3h [(28.93 ±3.54)ng／L, (37.92 ±6.73)ng／L,(18.93 ±3.25)mg／L] and postoperative 24h [(21.09 ±1.76)ng／L,(28.76 ±3.25)ng／L, (10.39 ±2.67) mg／L] were lower than those in the control group [3h after operation( 49.97 ±5.46) ng／L, (64.32 ±8.98)ng／L,(29.90 ±4.36) mg／L;24h after operation(34.52 ±3.49) ng／L,(43.65 ±5.61) ng／L, (18.89 ±2.34)mg／L] (3h after operationt＝20.704,15.064,12.917;24h after operationt＝22.001,14.706, 15.330,all P＜0.05).Conclusion Epidural anesthesia combined with general anesthesia has better clinical effect than general anesthesia alone in patients with hip replacement ,and can reduce the occurrence of cognitive dysfunction and inhibit the release of inflammatory reaction after operation ,which is worthy of clinical reference.