Davis F M, Laurenson V G
Anaesth Intensive Care. 1981 Nov;9(4):352-8. doi: 10.1177/0310057X8100900406.
One hundred and thirty-two elderly patients undergoing emergency hip surgery were randomly allocated to receive subarachnoid block (SAB) or general anaesthesia (GA). Using the 125.I fibrinogen uptake test, deep vein thrombosis was found to occur in 17 of 37 patients in the SAB group and 30 of 39 patients in the GA group (P 0.05). Blood loss was 513 ml (+/- SEM 44) in the SAB group and 714 ml (+/- SEM 67) in the GA group (P less than 0.01). Hypoxaemia was present preoperatively (mean PaO2 9.2 kPa). Immediately following general anaesthesia, the mean fall in PaO2 was 0.86 kPa compared with preoperative values but only 0.16 kPa following subarachnoid block (P less than 0.01). At 24 hours postoperatively the fall in PaO2 was similar in both groups and recovered only slowly during the first week. Twelve patients died, three in the SAB group and nine in the GA group. This difference in mortality was not statistically significant.
132例接受急诊髋关节手术的老年患者被随机分配接受蛛网膜下腔阻滞（SAB）或全身麻醉（GA）。通过125I纤维蛋白原摄取试验发现，SAB组37例患者中有17例发生深静脉血栓形成，GA组39例患者中有30例发生深静脉血栓形成（P<0.05）。SAB组失血量为513 ml（±标准误44），GA组为714 ml（±标准误67）（P<0.01）。术前存在低氧血症（平均动脉血氧分压9.2 kPa）。全身麻醉后即刻，与术前值相比，平均动脉血氧分压下降0.86 kPa，而蛛网膜下腔阻滞后仅下降0.16 kPa（P<0.01）。术后24小时，两组动脉血氧分压下降情况相似，且在第一周内恢复缓慢。12例患者死亡，SAB组3例，GA组9例。这种死亡率差异无统计学意义。
