Effect Of Combined Spinal-epidural Anesthesia With Hypobaric And Hyperbaric Bupivacaine On Postoperative Outcome Of Elderly Patients Undergoing Total Hip Arthroplasty

Objective:For elderly patients undergoing total hip arthroplasty,under the premise of the existing research on the dosage of bupivacaine,select bupivacaine with equal dosage but two different density(hypobaric and hyperbaric bupivacaine)for combined spinal-epidural anesthesia.By observing the postoperative outcome of patients,this study tries to explore whether there is any difference between the two kinds of density of bupivacaine spinal anesthesia solutions on the postoperative outcome of patients,and which specific density of bupivacaine has better postoperative outcome.Methods:In this study,the elderly patients undergoing total hip arthroplasty in Yan’an University Affiliated Hospital from January 2019 to February 2021 were selected according to the principle of randomization,control standard,and prospective,and all the patients were divided into two groups by the random numerical table.In group A,0.75%bupivacaine 1ml(7.5mg)and sterilized water for injection 1ml were used to prepare hypobaric liquid.Group B was treated with 0.75% bupivacaine 1ml(7.5mg),cerebrospinal fluid 0.9ml and 10% glucose injection 0.1ml.The intraoperative infusion volume,intraoperative bleeding volume and operation time were recorded and compared between the two groups.The comfort level,postoperative time of getting out of bed,postoperative length of hospital stays and postoperative complications were recorded and compared between the two groups.Results:1.Comparison of general data: there is no significant difference between the general data of patients in group A and group B in terms of gender,age,height,weight,ASA grade,and preoperative coexisting diseases(P>0.05).2.Comparison of operation conditions: There was no significant difference in transfusion volume,bleeding volume and operation time between group A and group B(P>0.05).3.Comparison of postoperative outcomes: In terms of comfort,group A is superior to group B,and the difference is statistically significant(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).In the time of getting out of bed,group A was superior to group B,and the difference was statistically significant(P<0.05).There was no significant difference in postoperative hospital stay between the two groups(P>0.05).Conclusion:Compared with the hyperbaric bupivacaine spinal anesthesia solution,the patients with hypobaric bupivacaine spinal anesthesia solution have higher comfort level and get out of bed earlier after operation,which is beneficial to the postoperative outcome of patients.Therefore,if the patient’s conditions permit,the combined spinal-epidural anesthesia with hypobaric bupivacaine can be given priority.