Analysis of application value of combined spinal-epidural anesthesia in patients with hip fractures
Objective To analyze the application effect of combined spinal-epidural anesthesia in patients with hip fractures.Methods 50 patients with hip fracture were randomly divided into a control group and an observation group,with 25 patients in each group.The control group received isobaric combined spinal-epidural anesthesia,while the observation group received hyperbaric combined spinal-epidural anesthesia.Both groups were compared in terms of anesthesia indexes(onset time of anesthesia,recovery time of motor block,recovery time of sensory block,postoperative waking time,dosage of anesthetic drugs),occurrence of adverse events(hypoxemia,elevated blood pressure,decreased blood pressure),anesthetic effect,blood pressure and heart rate before and after anesthesia,postoperative serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)].Results The onset time of anesthesia,recovery time of motor block,recovery time of sensory block and postoperative waking time of the observation group were shorter than those of the control group,and the dosage of anesthesia drugs was lower than that of the control group(P<0.05).After anesthesia,the diastolic blood pressure of the observation group was(73.43±8.02)mm Hg(1 mm Hg=0.133 kPa),the systolic blood pressure was(108.67±5.26)mm Hg and the heart rate was(85.34±5.48)beats/min,which were higher than(65.05±4.15)mm Hg,(90.35±7.69)mm Hg,(80.24±8.03)beats/min in the control group(P<0.05).The incidence of adverse events in the observation group was 8.00%,which was lower than 32.00%in the control group(P<0.05).After operation,the observation group had IL-6 of(104.52±30.13)ng/L,TNF-α of(1.74±0.24)ng/ml,CRP of(22.27±2.41)mg/L,which were lower than(132.46±30.02)ng/L,(2.51±0.25)ng/ml and(27.65±2.04)mg/L in the control group(P<0.05).The excellent and good rate of anesthesia in the observation group was 96.00%,which was higher than 68.00%in the control group(P<0.05).Conclusion The use of isobaric combined spinal-epidural anesthesia in patients with hip fracture can improve the effect of anesthesia and effectively reduce complications,and it is worthy of promotion.
Hip fracturesCombined spinal-epidural anesthesiaIsobaricHyperbaricAdverse events
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