Effect of Propofol Intravenous General Anesthesia Combined with Lumbar Epidural Anesthesia on Hemodynamics and Prognosis Recovery in Elderly Patients undergoing Hip Fracture Surgery
Objective To observe and explore the effect of propofol intravenous general anesthesia combined with spinal epidural anesthesia on perioperative hemodynamics and prognosis in elderly patients undergoing hip fracture surgery.Methods A total of 86 elderly patients who underwent hip fracture surgery at the hospital from November 2022 to November 2023 were selected as the research subjects.They were randomly divided into a control group and an observation group using a random number table method,with 43 cases in each group.The control group received combined spinal epidural anesthesia,while the observation group received propofol intravenous general anesthesia combined with spinal epidural anesthesia.The anesthesia excellence rate,perioperative hemodynamics,postoperative recovery time,postoperative pain,and cognitive function were compared between the two groups.Results The excellent anesthesia rate of elderly patients in the observation group was 97.67%,which was higher than 81.40%in the control group,and the difference was statistically significant(P＜0.05).Before anesthesia,there were no statistically significant differences in mean arterial pressure(MAP)and heart rate(HR)between the two groups(P＞0.05);there was no statistically significant difference in the levels of MAP and HR in the observation group at 10 minutes after anesthesia,30 minutes after anesthesia,and after surgery compared to before anesthesia(P＞0.05);the control group had higher levels of MAP and HR at 10 minutes after anesthesia,30 minutes after anesthesia,and after surgery compared to before anesthesia,and the observation group had lower levels of MAP and HR at 10 minutes after anesthesia,30 minutes after anesthesia,and after surgery compared to the control group,with a statistically significant difference(P＜0.05).There were no statistically significant differences between the observation group and the control group in terms of postoperative spontaneous breathing recovery time,postoperative monitoring and treatment roomobservation time,and eye opening time after breathing(P＞0.05);at 2 and 12 hours after surgery,the pain Visual Analog Scale score of the observation group were lower than those of the control group,and the differences between the groups were statistically significant(P＜0.05).Before surgery,there was no statistically significant difference in the scores of the Montreal Cognitive Assessment Scale(MoCA)between the two groups(P＞0.05);on the 1st and 3rd day after surgery,the MoCA scores of both groups were lower than before surgery,and the MoCA scores of the observation group were higher than those of the control group,with statistical significance(P＜0.05).Conclusion During the surgical treatment of elderly hip fracture patients,the combination of propofol intravenous general anesthesia and lumbar epidural anesthesia can stabilize intraoperative hemodynamics,reduce postoperative pain,improve postoperative cognitive function,enhance anesthesia effectiveness.
Elderly hip fracturesPropofolIntravenous general anesthesiaCombined spinal epidural anesthesiaHemodynamicsCognitive function
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