Comparison of epidural anesthesia combined with general anesthesia and conventional general anesthesia in elderly patients undergoing abdominal surgery

LUO Xiaogang

Abstract：Objective To compare the effect of epidural anesthesia combined with general anesthesia with that of general anesthesia on myocardial injury in elderly patients undergoing abdominal surgery. Methods Ninety-two cases of elderly patients who had received abdominal surgery in our hospital between January 2014 and December 2015 were equally divided into observation group and control group according to the methods of anesthesia. Patients in the control group were treated with general anesthesia, while the observation group was treated with epidural anesthesia combined with general anesthesia. Coagulation and fibrinolysis indicators, changes in myocardial function indicators, anesthetic effect, post-anesthetic awake time and the incidence of recovery restlessness were recorded at different time points and compared between the two groups of patients. Results APTT levels of patients in the observation group changed significantly 6 h and 12 h after surgery (P<0.05), so did APTT, PT, TT, FIB, and PLT levels in the control group (P<0.05). The level of FIB was significantly higher than in the observation group 12 h after surgery (P<0.05). There were significant changes in the levels of CK-MB and cTnI in both groups 6 h and 12 h after surgery (P<0.05). There was significant difference in the levels of CK-MB and cTnI between the two groups 6 h and 12 h after surgery (P<0.05). Both groups in 30 min into the skin incision surgery were significantly changed compared with before treatment. HR and MAP levels in the observation group were significantly lower than those of the control group 30 min into the skin incision surgery (P<0.05). The incidence of restlessness was significantly higher and post-anesthetic awake time was significantly shorter in the control group than in the observation group (P<0.05). Conclusion Epidural anesthesia combined with general anesthesia can reduce the effect on the fibrinolytic system and myocardial function in elderly recipients of abdominal surgery. Perioperataive circulation is stable, postoperative awake time is short, so this approach is worthy of popularization.