Effects of Combined Spinal Epidural Anesthesia in Orthopaedic Surgery of Elderly Patients.

OBJECTIVE: Combined spinal epidural anesthesia (CSEA) is applied to lower limb orthopaedic surgery in the elderly. This study is aimed at exploring the effect of CSEA in orthopaedic surgery of elderly patients.

METHODS: A total of 40 elderly patients with femoral fracture needing hip replacement or femoral head replacement in our hospital from June 2021 to June 2022 were selected as the research objects. The subjects were divided into observation group ( n = 20) and control group ( n = 20) by random number table method. The control group was given epidural anesthesia, while the observation group was given CSEA. Hemodynamic indexes (heart rate (HR) and mean arterial pressure (MAP)), visual analogue scale (VAS) pain score changes, anesthetic effects, and postoperative complications were compared between the two groups.

RESULTS: After operation, the observation group had lower HR and MAP values than the control group ( P < 0.05). The dosage of local anesthetics in the observation group was significantly less than that in the control group ( P < 0.05). The onset time and improvement time of sensory block in the observation group were significantly faster than those in the control group ( P < 0.05). The observation group had a lower VAS score than the control group ( P < 0.05). There was no significant difference in Bromage score or incidence of complications between the two groups ( P > 0.05).

CONCLUSION: The use of CSEA has good anesthetic effect. It has the disadvantage of no headache after traditional spinal anesthesia, is not limited by time, and can be used for postoperative analgesia, which is more suitable for the anesthesia of lower limb orthopaedic surgery in the elderly.