Effects of light-weight bupivacaine spinal anesthesia on anesthesia and circulatory system in elderly patients undergoing PFNA
Received:April 11, 2019  Revised:April 11, 2019
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Key words:bupivacaine; light specific gravity; anti-rotation proximal femoral nail; femoral intertrochanteric fracture; circulatory respiratory system
Author NameAffiliationE-mail
PENG Chunchao 青海省人民医院 pyong718@sohu.com 
吴婧文 青海省人民医院 34918405@qq.com 
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Abstract:
      Objective To investigate the effects of light-weight bupivacaine on the anesthetic effect and respiratory and respiratory effects of elderly patients with anti-rotation femoral proximal intramedullary nailing (PFNA). Methods Sixty elderly patients who underwent PFNA in our hospital from August 2015 to August 2018 were randomly divided into two groups, 30 in each group. The weight was anesthetized with 3 mL of glucose solution containing 0.5% bupivacaine. Lightly anesthetized with 6 mL of distilled water containing 0.25% bupivacaine. Compare the anesthetic effects of the two groups. The sedation and circulatory system changes before and after anesthesia (T0), anesthesia plane fixation (T1), 5 min (T2), 15 min (T3), 30 min (T4), and 1 h (T5) were measured and compared. Patients' cognitive status was assessed using the Mini Mental Condition Scale (MMSE). The incidence of adverse reactions in patients was counted. Results: The anesthetic onset time were basically the same (P>0.05). The ratio of light to specific anesthesia tissue plane ≥T10 was significantly lower than that of weight ratio recombination (P < 0.05). The use rate of lighter than recombinant ephedrine and atropine was significantly lower than that of weight-to-recombinant (P<0.05). There was no significant difference in T0~T5 Ramsay score between the two groups (P>0.05). There was no significant difference in MAP, heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate and SpO2 between the two groups before anesthesia (P>0.05). At the T2~T5 time point after anesthesia, MAP, heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate and SpO2 were significantly lower in the two groups, but the weight was more significant than the recombination (P<0.05). After anesthesia, the lighter than recombinant MMSE score was higher than the weight ratio recombination (P<0.05). The incidence of cognitive dysfunction was significantly lower than that of recombinant recombination (P<0.05). The incidence of adverse reactions in weight-to-recombination and light-weight recombination were 46.67% and 23.33%, respectively. Conclusion: The low concentration of spinal anesthesia in senile patients undergoing PFNA can achieve satisfactory anesthetic effect, with less effect on the circulatory system, effectively improve the quality of anesthesia recovery, and have higher safety, it is worth further application in clinical practice.
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