Study Of Using Two Doses Of Sufentanil Plus Bupivacaine In Spinal Anesthesia For Total Knee Arthroplasty In Elderly Patients

Objective We aimed to compare the anesthesia effects and adverse reactions of two doses of sufentanil and fentanyl combined with bupivacaine for elderly total knee arthroplasty,to study the safety and effectiveness of sufentanil combined with bupivacaine in spinal anesthesia,to provide a reference for the anesthesia methods of elderly total knee arthroplasty.Methods Selecting 90 elderly patients who underwent elective total knee replacement surgery in the People’s Hospital of Ningxia Hui Autonomous Region From June 2020 to October 2020;They were randomly allocated to fentanyl 50ug(BF)、 sufentanil 5ug(BS1)、 Sufentanil 10ug(BS2),30 cases in each group,among BF group: fentanyl50ug+0.75% bupivacaine 2ml;BS1 group: sufentanil 5ug+0.75% bupivacaine 2ml+Cerebrospinal fluid 0.9ml;BS2 group: Sufentanil 10 ug + 0.75% bupivacaine 2ml +cerebrospinal fluid 0.8ml;Record the age、gender、 height、 weight、 education level of each group of patients 、 ASA classification 、 affected limb information 、 fluid intake 、General information such as the length of the operation;Recording the non-invasive systolic blood pressure、diastolic blood pressure、heart rate and respiratory rate of the three groups of patients before anesthesia(T0),immediately after anesthesia(T1),5min(T2),10min(T3),15min(T4),30min(T5),60min(T6)and completion of the operation(T7);Recording the anesthesia onset time、highest block level、effective analgesia duration、highest Ramsay sedation score during surgery、VAS analgesia score for the first three days after surgery、the cumulative amount of remedial analgesics and the incidence of adverse reactions;Performing the Data analysis by SPSS19.0 statistical software.Results(1)Comparison of the general data of the three groups of patients,the difference was not statistically significant(P>0.05);(2)Comparison of the blood pressure 、 pulse at each time point,the difference was not statistically significant(P>0.05);(3)At the T2,T3,T5 time point,respiratory rate of BS2 group was lower than that of the BS1 and BF group,and the difference was statistically significant(P<0.05);also,at the T6 and T7,the respiratory rate of the BS2 group was lower than that of the BF group,and the difference was statistically significant(P<0.05);(4)Comparison of the effective duration of pain between three groups,there was no statistically significant difference(P>0.05);compared with the onset time of anesthesia,the time of the BS2 group was shorter than that in the BS1 and BF groups(P<0.017)(4)Adverse reactions: compared with the hypotension 、 hypercardiac 、bradycardia 、 nausea and vomiting,there was no statistical difference(P>0.05);the incidence of pruritus in the fentanyl group was higher than that in the sufentanil group,and the difference was statistically significant(P<0.05).Conclusion The results of this study show that sufentanil 10 ug and 5ug all could be safely used in elderly total knee arthroplasty without causing serious adverse reactions,and the incidence of itching is lower;compared with sufentanil 5ug,sufentanil 10 ug anesthesia takes effect faster.