Application of oxycodone combined subarachnoid block in the elderly patients with femoral trochanter fracture surgery / 临床麻醉学杂志

ABSTRACT

Objective To investigate the advantages and disadvantages of oxycodone combined subarachnoid block and intravenous-inhalational anesthesia in elderly patients with femoral trochanter fracturethe surgery.Methods Thirty-four patients undergoing elective surgery with closed reduction and Proximal femoral nail anti-rotation (PFNA) fixation,13 males and 21 females,aged 76-92 years,ASA physical status Ⅱ or Ⅲ,were equally randomized into two groups (n =17 each)group O and group C.Patients in group O received oxycodone combined subarachnoid block.Patients in group C received intravenous-inhalational anesthesia.Patients in group C were not premeditated beforel entering the operation room.After entering the rooms group O was given oxycodone 3-5 mg i.v first,then given ropivacaine in subarachnoid space.All patients were induced with intravenous of sulfentanil 0.2-0.3μg/kg,cisatracurium 0.15 mg/kg,etomidate 0.1-0.2 mg/kg slowly.Anesthesia was maintained by intravenous propofol 3-5 mg· kg-1 · h-1,remifentanyl 0.1-0.3 μg · kg-1 · h-1,sevofrane 0.55％-2％ infusion,intravenous bolus cisatracurium 0.05-0.10 mg/kg.The anesthesia related complications and length of hospital stay were recorded.Results Postoperative nausea and vomiting (PONV) respiratory depression of group O was significantly lower than that of group C [2(11.8％) cases vs 9 (52.9％) cases,P＜0.05],length of hospital stay of group O was significantly shorter than that of group C [(10.4±1.6) d vs (15.8±2.0) d,P＜0.05].Conclusion In the elderly patients with femoral intertrochanteric fracture closed reduction and PFNA internal fixation,oxycodone combined subarachnoid block may improve patients' recovery.