Objective:To compare the complications of anesthesia between nerve blockade and intraspinal anesthesia in surgeries of single leg in aged.Methods:66 cases for surgeries of single leg,who aged between 65 and 85 years old with ASA in grade Ⅰ to Ⅲ were randomly divided into group with epidural anesthesia(E group) and group with nerve blockade(NB group).NB group was divided into two subgroups: S+F group(n=22) and F+L group(n=22).NB group received nerve blockade located by nerve stimulator,sciatic nerve combined with femoral nerve blockade for surgery in inferior knee joint,or sciatic nerve combined with lumbar plexus blockade for surgery in hip joint and shaft of femur.E group received lidocayin through puncture between L3 and L4 and controlling anesthesia in T10.Before anesthesia and at 15,30,60 min after anesthesia and ended time,the BP,HR and SpO2 were observed.The onset time of anesthesia was recorded,and the duration of analgesia and residence time of motion was followed up.The occurrence of toxic effect and hypotension during operation and complications including urine retention and nausea and vomiting were observed.The efficacy of anesthesia was evaluated based on criteria of nerve blockade grading.Results:In NB group,the hemodynamics was steady.The surgeries were successful with less postoperative complications and better maintaining analgesia.Conclusion: Nerve blockade is safe and feasible technique for aged patients receiving surgies of single leg,with stable circulation,perfect anesthetic effect and less adverce effect and quick recovery.
Objective:To evaluating the effect of esmolol combined with nitroglycerin during induced hypotension on hypertension patients in spinal surgery.Methods: 60 patients were randomly divided into two groups:group I(n=30)was simple nitroglycerin;groupⅡ(n=30) was esmolol combined with nitroglycerin.Group I initially received nitroglycerin at 2.5 μg/(kg·min)-1and group Ⅱ initially received nitroglycerin2.5 μg/(kg·min)-1and esmolol12.5 μg/(kg·min)-1.The nitroglycerin dosage was adjusted to maintain the MAP level at target in two groups.Hemodynamic parameters were recorded before controlled hypotension,just at the moment of controlled hypotension(T0)、30 min after controlled hypotension(T1)、60 min after controlled hypotension(T2)、15 min after controlled hypotension(T3).Also the operating time、intra-operative blood loss、blood transfusion amounts and urine were recorded.Results:The MAP level of two groups were all significantly decreased during controlled hypotension(P0.01).HR change of groupⅡ in T0,T1,T2 was lower than group Ⅰ(P0.05).There were no deficiency in the intra-operative blood loss 、 blood transfusion and urine between both groups(P0.05),The duration of operation was significant shorter in group Ⅱ than in group Ⅰ、and the duration of recovering was shorter in group Ⅱ(P0.05).Conclusions:Nitroglycerin combined with esmolol can decrease the intra-operative blood loss and blood transfusion amounts,prevent the reflex enhancement of HR and reduce the duration of operation.So it is safe and effect for controlled hypotension on hypertension patients in spinal surgery.
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