Abstract:Objective To analyze and discuss the effect of cardiopulmonary function of patients with senile femoral neck fracture who underwent hip arthroplasty using hypobaric spinal anesthesia combined with epidural block and general anes-thesia. Methods A retrospective study was performed on 120 patients with senile femoral neck fracture who underwent hip arthroplasty from February 2015 to February 2016. Patients were divided into Group A and Group B according to different anesthesia methods,with 60 cases in each group. Patients in Group A were performed hypobaric spinal anesthesia combined with epidural block,and the others in Group B were performed general anesthesia. The cardiopulmonary function changes of patients during the surgery were observed and the anesthesia effects were compared the two groups. Results The incidence of hypertension,bradycardia and anoxia in Group A were significantly lower than those in Group B,and the difference was statistically significant(P<0. 05);the incidence of hypotension between the two groups has no statistically significant differ-ence(P>0. 05). The anesthesia onset time of Group A was significantly shorter than that of Group B,and the difference was statistically significant(P<0. 05);the postoperative analgesic effects in VAS scores,in total good rate and in total satisfac-tion rate of muscle relaxation had no statistically significant difference(P>0. 05). Conclusion Both of hypobaric spinal anesthesia combined spinal epidural and general anesthesia have good effect,and both of them can achieve a standard anal-gesic effect. Furthermore,due to the impact of cardiopulmonary function in hypobaric spinal anesthesia combined with epi-dural block is less than general anesthesia,we should priority use hypobaric spinal anesthesia combined with epidural block in perioperative hip arthroplasty.

Abstract:Dexmedetomidine is a highly selective α2 adrenoreceptor agonist,which exhibits a wide range of effects,including sedation,analgesia,antianxiety and sympatholytic properties.As an anaesthetic adjuvant,it is widely used in operative processes and ICU sedation.Recently,in a good deal of animal experiments,dexmedetomidine has been demonstrated that it has neuroprotective effects,such as the function of adjusting cerebral blood flow and cerebral oxygen supply.It may be relat-ed to attenuating sympathetic activation,dropping heart rate,increasing oxygen supply while decreasing the consumption,so that it can keep the myocardial oxygen balance complications.In addition,by the binding of dexmedetomidine andα2 A sub-type receptor,the neuroprotective effects might be related with receding the excitatory toxicity of glutamate.On the other hand,it can attenuate catecholamine release,improve the blood perfusion of ischemia area,and adjust the apoptosis of neu-ron cells,etc.In the mean time,dexmedetomidine may be involved in the other adjusting of cell function.In conclusion,the exact mechanisms of its neuroprotective effects are still unclear,and are confined to the animal experiments.Future clinical research need to aim at investigating the molecular and genetic mechanisms of its cardioprotective effects.