Liang Chengwei, Wei Jionglin, Cai Xiaoxi, Lin Weilong, Fan Yongqian, Yang Fengjian
Department of Orthopedic Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, China (mainland).
Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China (mainland).
Med Sci Monit. 2017 Aug 2;23:3752-3759. doi: 10.12659/msm.902768.
BACKGROUND This study compared the efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty (THA). MATERIAL AND METHODS We allocated 198 patients preparing to undertake THA into 3 groups: general anesthesia group (GA group, n=66), caudal epidural anesthesia group (CEA group, n=66), and spinal-epidural anesthesia group (SEA group, n=66). We compared postoperative adverse effects occurring in patients of the 3 anesthesia groups. The Visual Analog Scale (VAS) score, Minimum Mental State Examination (MMSE) score, and β-amyloid (Aβ) expression were calculated to determine the effects of different anesthesia on the postoperative pain and cognitive dysfunction of patients. RESULTS The CEA and SEA groups had lower rates of perioperative adverse effects than in the GA group. Patients in the GA group required significantly higher administration of analgesics after the surgery than those in CEA and SEA groups. Higher Aβ expression levels and VAS scores, as well as lower MMSE scores, were also seen in the GA group compared with the other 2 groups. CONCLUSIONS CEA and SEA were more effective than GA in THA, and CEA seemed to be a better anesthesia technique than SEA.
背景 本研究比较了全髋关节置换术(THA)中使用的3种不同麻醉技术的疗效和安全性。
材料与方法 我们将198例准备接受THA的患者分为3组:全身麻醉组(GA组,n = 66)、骶管硬膜外麻醉组(CEA组,n = 66)和腰麻-硬膜外联合麻醉组(SEA组,n = 66)。我们比较了3组麻醉患者术后出现的不良反应。计算视觉模拟评分(VAS)、简易精神状态检查表(MMSE)评分和β-淀粉样蛋白(Aβ)表达水平,以确定不同麻醉方式对患者术后疼痛和认知功能障碍的影响。
结果 CEA组和SEA组围手术期不良反应发生率低于GA组。GA组患者术后所需镇痛药的用量明显高于CEA组和SEA组。与其他两组相比,GA组的Aβ表达水平和VAS评分更高,MMSE评分更低。
结论 在THA中,CEA和SEA比GA更有效,且CEA似乎是比SEA更好的麻醉技术。