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Optimized Anesthesia Method in Elderly Patients with Coronary Heart Disease Undergoing Lower Extremity Surgery

Author: YeJianRong
Tutor: ZhengHong
School: Xinjiang Medical University
Course: Anesthesiology
Keywords: Anesthesia methods coronary heart disease unilateral lower extremity surgery elderly patients safety and effective
CLC: R614
Type: Master's thesis
Year: 2009
Downloads: 55
Quote: 0
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Abstract


Objective: To evaluate three types of anesthesia methods which are most safe and effective in elderly patients with coronary heart disease undergoing unilateral lower extremity surgery Methods: Following Ethical Committee approval and informed consent 45 patients, according to NYHA (New York Heart Association) classification for cardiac functionⅠ~Ⅱ, scheduled for undergoing unilateral lower limb surgery in elderly patients with coronary heart disease were randomly devided into three groups of 15 patients each, (N group) nerve stimulator guided lumbar plexus plus the sciatic nerve; (G group) general anesthesia ; epidural anesthesia (E group). N group: nerve stimulator to guide lumbar plexus plus the sciatic nerve. E group: select L2 ~ 3 epidural space. G groups: anesthetic were used Vecuronium、Midazolam and Fentanyl for induction of anesthesia respectively, maintenance of anesthesia with propofol, Fentanyl and Vecuronium. Monitored and recorded SBP (systolic blood pressure), HR (heart rate), SPO2 (pulse blood oxygen saturation),as well as ECG ST-T changes befor and after surgery 10 min, 20 min, 30 min, 40 min and at the end of the surgery. Followed three days of cTnI ( troponinⅠ) changes after surgery. Results: E group compared with other groups, SBP were decreased significantly( P <0.05). G group hypertension and tachycardia incidence ratio was 87% and 80%. cTnI in N group was lower(P <0.05) in the first and third day compared with G group. As for perioperative ECG ST-T changes, G group compared with other groups was higher (P <0.05). Conclusion: The regional nerve nerve block by stimulator guide is the most safety and effective method than general anesthesia or epidural anesthesia in elderly patients with coronary heart disease undergoing unilateral lower extremity surgery.

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CLC: > Medicine, health > Surgery > Surgical operation > Anesthesiology
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