Comparison of Low Dose Light Specific Gravity Combined Spinal-Epidural Anesthesia and Femoral and Sciatic Nerve Block Anesthesia for Internal Fixation in Elderly Patients with Traumatic Lower Limb Fractures
Comparison of Low Dose Light Specific Gravity Combined Spinal-Epidural Anesthesia and Femoral and Sciatic Nerve Block Anesthesia for Internal Fixation in Elderly Patients with Traumatic Lower Limb Fractures
Objective To investigate the application of low-dose light specific weight combined lumbar hard anesthesia and anesthesia with femoral nerve and sciatic nerve block for internal fixation in elderly patients with traumatic lower extremity fractures(TLEF).Methods Eighty elderly patients with TLEF who were admitted to Nanyang Central Hospital from May 2020 to may 2022 were randomly selected for this study.They were equally divided into a control group(forty cases)and a study group(forty cases)using a random number method.Both groups of patients were treated with internal fixation.The control group received low dose light specific gravity combined spinal epidural anesthesia during operation.The study group received intraoperative femoral and sciatic nerve block anesthesia.the anesthesia effects,changes in vital signs,coagulation function,postoperative adverse reactions and complications,and postoperative recovery were compared between the two groups.Results There were no differences between the two groups in terms of onset time,total anesthesia time,sensory nerve total anesthesia time,and motor nerve total anesthesia time(P＞0.05).After anesthesia,the levels of heart rate(HR)and mean arterial pressure(MAP)in both groups were lower than before anesthesia(P＜0.05).There were no differences in HR and MPA levels between the two groups after anesthesia(P＞0.05).After surgery,the levels of thrombin time(TT),prothrombin time(PT)and activated partial thromboplastin time(APTT)in both groups were higher than those before surgery,while those in the study group were higher than those in the control group(P＜0.05),the levels of fibrinogen(FIB)in the two groups were lower than those before surgery,while those in the study group were lower than those in the control group(P＜0.05).There was no difference in postoperative adverse reactions between the two groups(P＞0.05).The postoperative recovery time,extubation time,lower limb movement recovery time and urination recovery time in the study group were lower than those in the control group(P＜0.05).Conclusion Both low-dose hypobaric spinal-epidural anesthesia and femoral nerve and sciatic nerve block anesthesia have good anesthetic effects during internal fixation in elderly patients with TLEF.However,femoral nerve and sciatic nerve block anesthesia can significantly reduce the hypercoagulable state of blood,reduce the adverse reactions of anesthesia,and effectively promote the postoperative recovery of patients.
关键词
创伤性下肢骨折/内固定术/小剂量轻比重腰-硬联合麻醉/股神经及坐骨神经阻滞麻醉/麻醉效果
Key words
traumatic lower limb in the elderly/internal fixation/low dose light specific gravity combined spinal epidural anesthesia/femoral and sciatic nerve block anesthesia/anesthetic effect
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