Analysis of anesthesia effect of combined spinal-epidural anesthesia and general anesthesia in elderly patients with lower extremity fracture
Objective To explore the anesthesia effect of combined spinal-epidural anesthesia and general anesthesia in elderly patients with lower extremity fracture.Methods 90 elderly patients with lower extremity fracture were studied and divided into an observation group and a control group according to random number table method,with 45 cases in each group.The control group was given general anesthesia,and the observation group was given combined spinal-epidural anesthesia.Comparison was made on visual analogue scale(VAS)score,mini-mental state examination(MMSE)score,coagulation index[thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)]and surgery-related indicators between the two groups.Results At 6,12 and 24 h postoperatively,VAS scores of the observation group were(3.75±1.51),(2.17±0.17)and(0.64±0.35)points,which were lower than(4.55±1.74),(3.99±0.25)and(2.18±0.55)points of the control group.The data were statistically significant(P<0.05).There was no statistical significance in MMSE scores between the two groups preoperatively and at 72 h postoperatively(P>0.05).MMSE scores of the observation group were(26.45±1.56),(27.07±1.48)and(28.39±1.41)points at 6,12 and 24 h postoperatively,which were higher than(20.02±1.31),(26.15±1.22)and(27.26±1.38)points of the control group.The data were statistically significant(P<0.05).At 1 h postoperatively,TT,PT and APTT in the observation group were(17.69±1.14),(11.70±1.33)and(37.03±2.42)s,which were longer than(16.46±1.57),(10.36±1.16)and(35.60±2.25)s in the control group.The data were statistically significant(P<0.05).There was no significant difference in total anesthesia time,total operation time and intraoperative blood loss between the two groups(P>0.05).Conclusion In the anesthesia of elderly patients with lower extremity fracture,the anesthetic effect of general anesthesia is comparable to that of combined spinal-epidural anesthesia.Combined spinal-epidural anesthesia can better relieve pain,maintain coagulation function,accelerate cognitive function recovery,and can be popularized.
Lower extremity fractureCombined spinal-epidural anesthesiaGeneral anesthesiaAnesthesia effectOld age
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