| Objective To summarize the experiences of the clinical practice ofcombined spinal-epidural anesthesia in patient older than75years，providea reference for clinical anesthesia.Methods A retrospectively analysis was done in56cases of olderthan75years, which had been collected during the period of Jan. to Nov. of2013in our hospital. The focused on items including that the onset andduration of anesthesia, the hemodynamic changes and supplementary drugsused during anesthesia and the complications after anesthesia.Results Average time began to appear anesthesia after subarachnoidinjection is54seconds (54±10), average time of fixed block is5.8minutes(5.8±1.2),and the heighest level of anesthesia appears at T8-10interspace.Compared to T0(baseline values before anesthesia), the MAP(meanarterial pressure) after anesthesia decreased (p <0.05), but all the data werein the normal range. The patients’ vital signs during anesthesia were stable,and all the surgeries were completed under the spinal-epidural anesthesia. One patient was given ephedrine because of low MAP and one patientneeded antihypertensive treatment because the MAP increased more than30%of baseline before anesthesia, and one patient needed atropine0.5mg tocorrect heart rate, the remaining patients had stable vital signs.Nosignificant respiratory depression was observed, and all of the pulse oxygensaturation level are maintained at over96%. Nine patients need extra localanesthetic added through the epidural catheter,21patients were givenfentanyl, midazolam or propofol as assistance drugs. No patients withnausea, vomiting, headache and other phenomena were observed, andearly anesthetic complications were not be observed also.Conclusions With a rapid onset, improve results, combinedspinal-epidural anesthesia can be used safely in patients older than75years.Fully preanesthetic preparations and excellent management of anesthesiaduring the operation is benefit for the success and security of anesthesia. |
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