Comparison of different anesthesia techniques on early prognosis in patients undergoing hip joint replacement

Abstract

Objective To compare the effects of different anesthesia techniques on early prognosis in patients undergoing hip joint replacement. Methods The demographic, preoperative and postoperative data of 478 patients, aged 18-95 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅳ, who underwent elective unilateral hip joint replacement in Tongji Hospital from May 2014 to December 2016, were retrospectively analyzed.Patients were divided into general anesthesia group (group GA, n=197), peripheral nerve block group (group PNB, n=147) and peripheral nerve block combined with general anesthesia group (group PNB+ GA, n=134). The amount of crystalloid solution and colloid solution infused, consumption of sufentanil and requirement for vasoactive agents were recorded during operation.The duration of anesthetic recovery room stay, length of hospital stay before and after operation and total length of hospital stay were recorded.The development of complications within 48 h after operation, therapy after admission to intensive care unit and in-hospital fatality were also recorded. Results Compared with group GA, the intraoperative consumption of sufentanil was significantly decreased in group PNB+ GA, and the amount of crystalloid solution infused, urine output, consumption of sufentanil, requirement for vasoactive agents and incidence of postoperative hypoxemia, pulmonary infection and acute cerebral infarction were significantly decreased in group PNB+ GA (P<0.05). Compared with group PNB+ GA, the consumption of sufentanil, requirement for vasoactive agents and incidence of postoperative hypoxemia, pulmonary infection and acute cerebral infarction were significantly decreased in group PNB (P<0.05). Conclusion Compared with general anesthesia or with peripheral nerve block-general anesthesia, peripheral nerve block is more helpful in improving early prognosis in patients undergoing hip joint replacement. Key words: Arthroplasty, replacement, hip; Nerve block; Lumbosacral plexus