Post-operative influence of different anesthesia methods on the elderly patients with coronary heart disease undergoing unilateral lower extremity surgery

Objective To evaluate and analyze three anesthesia methods in the elderly patients with coronary heart disease undergoing unilateral lower extremity surgery.Methods Sixty-five elderly patients with coronary heart disease undergoing unilateral lower extremity surgery were randomly divided into three groups: group N receiving nerve stimulator guided lumbar plexus plus sciatic nerve(n=21),group G receiving induction anesthetic with vecuronium,midazolam and fentanyl followed by maintenance anesthesia with propofol(n=19),and group E receiving epidural anesthesia in L2-3 epidural space(n=25).All patients were observed and recorded the ECG ST-T changes,the major adverse cardiac events,troponin Ⅰ changes three days after surgery,and resting/postexercise VAS scores in postoperative 24,48 and 72 hours.Results Post-operative troponin Ⅰwas significantly lower in group N than that in group G(P0.05) on the first postoperative day,and than that in group E and group G on the third postoperative day(P0.05).The ECG ST-T changes were more obvious in group G than those in group N and group E on the first postoperative day(P0.05).The incidence of the hypertension was higher in group G than that in group N and group E in postoperative three days(P0.05),and mainly occurred on the first day(P0.05).VAS scores were higher in quiescent condition in 24,48 and 72 hours,and in post-exercise condition in 24 and 72 hours in group G than those in group E and N.Conclusion The nerve stimulator guided nerve block has a satisfactory anesthesia effect.VAS score is not significantly different from that of epidural anesthesia.It has a slight influence on ECG ST-T and almost does not injure the myocardium.