Clinical study of combined spinal epidural anesthesia and general anesthesia on total hip replacement in elderly patients

Abstract

Objective To compare the effect of combined spinal epidural anesthesia and general anesthesia on total hip replacement.Methods Thirty-six cases were randomly divided into the spinal-epidural anesthesia group(group A) and general anesthesia group(group B),and there were 18 cases in each groups.Both groups of patients' perioperative heart rate(HR),blood pressure(BP),SpO2,mental condition,operative time,time of exercise out of bed and length of hospital stay were recorded.Results After anesthesia,both groups' BP were significantly lower than before anesthesia (P ＜ 0.01),but there had no significant difference between the two groups (P ＞ 0.05).In all patients,the BP decreased significantly just after injection of bone cement (P ＜ 0.01).Hypotension incidence in group B was 44.4％ (8/18),significantly higher than that in group A(27.8％,5/18) P ＜0.05.The BP and HR when extubating of tracheal intubation in group B was higher than that in group A (P ＜ 0.05).There was no significant difference in operative time,time of exercise out of bed and length of hospital stay between the two groups.The incidence of psychiatric symptoms of group A and group B were 50.0％ and 38.9％,the difference was not statistically significant.Conclusions Both anesthesias can be used in total hip arthroplasty.Besides,it's the key point that the moment when bone cement was injected,so getting ready to rescue is essential.However,hypotension incidence in combined spinal epidural anesthesia is lower than that in general anesthesia,which meant that combined spinal epidural anesthesia is more safe. Key words: Hip replacement surgery; Spinal-epidural anesthesia; Anesthesia; Elderly