Safe Use of Intraspinal Anesthesia in Geriatric Orthopedic Surgery and Its Effect on Coagulation Factors.

IF 2.1 4区 医学 Q2 SURGERY Journal of Investigative Surgery Pub Date : 2024-12-01 Epub Date: 2024-11-11 DOI:10.1080/08941939.2024.2419138
Jing Xiang, Yi Sun, Jingbo Pi
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Abstract

Objective: This study aimed to observe the safe use of intraspinal anesthesia in geriatric orthopedic surgery and its effect on coagulation factors.

Methods: The anesthesia indices, cognitive functions, hemodynamic indicators, along with coagulation function indices were compared. The duration of anesthesia was compared between the two groups. Adverse reactions occurring in the two groups of patients were compared.

Results: The time to awaken, time to open eyes, time to the verbal statement, the onset of anesthesia, duration of sensory blockade, and duration of motor nerve blockade were shorter while the duration of analgesia was longer in the observation group than in the control group. The observation group's postoperative Mini-Mental State Examination scores were higher than those of the control group. Heart rate and mean arterial pressure of the patients in the observation group at 10 min after anesthesia and at the end of surgery were lower versus those in the control group. The observation group had lower levels of von Willebrand factor (%) and fibrinogen at 10 min after anesthesia and at the end of surgery than the control group, and lower levels of the thrombin-antithrombin complex at the end of surgery than the control group. The observation group exhibited a lower incidence of adverse reactions in contrast to the control group.

Conclusion: The application of intraspinal anesthesia in geriatric orthopedic surgery has a significant and remarkable effect, with less impact on patients' hemodynamics and postoperative cognitive function, and can improve patients' blood hypercoagulability.

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在老年骨科手术中安全使用椎管内麻醉及其对凝血因子的影响。
研究目的本研究旨在观察椎管内麻醉在老年骨科手术中的安全应用及其对凝血因子的影响:方法:比较麻醉指数、认知功能、血流动力学指标以及凝血功能指数。比较两组患者的麻醉持续时间。比较两组患者发生的不良反应:结果:与对照组相比,观察组的苏醒时间、睁眼时间、语言陈述时间、麻醉开始时间、感觉阻滞时间和运动神经阻滞时间更短,而镇痛时间更长。观察组的术后迷你精神状态检查评分高于对照组。观察组患者在麻醉后 10 分钟和手术结束时的心率和平均动脉压均低于对照组。观察组在麻醉后 10 分钟和手术结束时的冯-威廉因子(%)和纤维蛋白原水平低于对照组,手术结束时的凝血酶-抗凝血酶复合物水平也低于对照组。观察组的不良反应发生率低于对照组:椎管内麻醉在老年骨科手术中的应用效果显著,对患者的血流动力学和术后认知功能影响较小,能够改善患者的血液高凝状态。
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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