Comparison of anesthesia methods for elderly patients undergoing unilateral lower limb surgery

Abstract

Objective To probe into safety of anesthesia methods for elderly patients undergoing unilateral lower limb surgery.Methods Sixty elderly patients,aged 80 y-99 y,scheduled for unilateral lower limb surgery,were randomly divided into nerve block group (group N) and hypobaric spinal anesthesia group (group S).Group N received lumbar plexus and sciatic nerve block,while group S underwent hypobaric spinal anesthesia.The patients' mean arterial pressure(MAP),the heart rate(HR) and the blood oxygen saturation(SpO2) before the anesthesia as well as the 1,3,5,10,15,30 min,1,2 h after the anesthesia and by the end of the operation.Dose of local anesthetic dosage,onset time of anesthesia complete block time,adjuvant drug,level of sensory block were documented anesthesia effects,side effects and complications were observed.Results MAP,HR and SpO2 in group N were (156±15) mm Hg (1 mm Hg=0.133 kPa),(85±7) beats/min,(98.5±1.5)％(P＞0.05) respectively 10 min after the anesthesia.MAP,HR and SpO2 in group S were (99±11) mm Hg,(99±5) beats/min,(98.5±1.5)％(P＜0.05) respectively 10 min after the anesthesia.There was significant difference in MAP between group N and group S (P＜0.05).No significant difference was detected in HR between two groups.Highly significant difference in group N was found in SpO2 before and after the anesthesia (P＜0.01).There was significant difference in SpO2 in group S before and after the anesthesia.However,no significant difference was detected in SpO2 between two groups.The incidence of hypotension shivering,nausea and vomiting in group S higher (P ＜0.05,P ＜0.01).Conclusions Lumbar plexus and sciatic nerve block is safer than hypobaric spinal anesthesia,for elderly patients undergoing unilateral lower limb surgery.The patients receiving lumbar plexus and sciatic nerve block have more stable,hemodynamics and fewer complications.Lumbar plexus and sciatic nerve block would be one of anesthesia methods for elderly patients undergoing lower limb surgery who areis neither suitable for spinal anesthesia nor general anesthesia. Key words: Lumbar plexus and sciatic nerve block; Elderly patients; Unilateral; Lower limb surgery; Hypobaric spinal anesthesia