Impacts of Anesthesia Methods on Perioperative Management and Prognosis of Knee Arthroplasty in Patients with Kashin-Beck Disease at High Altitudes

Deng Chengqi; Huang Shengchuan; Kong Zhenzhen; Silang Wangmu; Zheng Xiangqian; Yin Yiqing

doi:10.3969/j.issn.1004-3403.2025.01.009

Abstract：Objective To retrospectively analyze the Impacts of anesthesia methods on perioperative management and prognosis of knee arthroplasty in patients with Kashin-Beck disease at high altitudes.Methods 76 patients with plateau Kashin-Beck disease admitted in the Tibetan Hospital of Changdu from September,2022 to October,2023,in-cluding 31 males and 45 females,aged from 41 to 83,with BMI from 17.33 to 33.73 kg/m2,and ASA grades from Ⅰ toⅢ.The patients were divided into general anesthesia(GA)group(n=26)and intraspinal anesthesia group(IA,n=50)according to different anesthesia methods.The patients'basic preoperative conditions,the values of pH,PaCO2,PaO2,SaO2and the change of PaO2 in preoperative and intraoperative blood gas analyses,and knee VAS scores,HSS scores,and complications in 1 month postoperatively were collected.Results Compared with IA group,the anesthesia time in GA group was significantly prolonged(P＜0.05).There was no significant difference in pH,PaO2,PaCO2 and SaO2 between the 2 groups in preoperative blood gas analysis(without oxygen inhalation)(P＜0.05).Compared with IA group,pH value in blood gas analysis in GA group was significantly decreased,and PaO2,PaCO2 and SaO2 values were significantly increased(P＜0.05).The change of PaO2 during and before operation in GA group was(155.46±78.01)mmHg,which was significantly higher than that in IA group(35.55±23.19)mmHg(P＜0.05).There was no sig-nificant difference in knee pain score,HSS score,complication rate and mortality between the 2 groups within 1 month after surgery(P＞0.05).Conclusion Compared with intraspinal anesthesia,general anesthesia can significantly improve the perioperative oxygenation of patients undergoing knee arthroplasty with plateau Kashin-Beck disease,but there was no significant difference in the prognosis of patients within 1 month after surgery among different anes-thesia methods.