Retrospective Study On Postoperative Complications Of Bupivacaine-fentanyl Isobaric Spinal Anesthesia Of Lower-limb Orthopaedic Surgery In Elderly Patients

Objective: By reviewing the rates of postoperative complications of bupivacaine-fentanyl isobaric spinal anesthesia of lower-limb orthopaedic surgery in elderly patients,To evaluate the safety of bupivacaine-fentanyl isobaric spinal anesthesia in the application of lower limb orthopedic surgery in elderly patients,and to provide reference for clinical anesthesia.Methods: Reviewing the hospitalization information of elderly patients who underwent lower limb orthopedic surgery at the People’s Hospital of Ningxia Hui Autonomous Region from January 2013 to December 31,2019,they were divided into general anesthesia group and spinal anesthesia group according to the anesthesia method,and general patient information(age,Gender,BMI,type of surgery,preoperative comorbidities,ASA classification,method of anesthesia,length of operation,length of hospital stay),intraoperative systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and postoperative complications;After data sorting out,describe and discuss the intraoperative hemodynamics and postoperative complications,compare the effects of spinal anesthesia and general anesthesia on intraoperative hemodynamics and postoperative complications,analyze and use binary logistic to analyze the patients admitted to the ICU Risk factorsResults: A total of 2589 lower limb orthopedic surgery patients were collected,1916 qualified cases were collected,and 673 non-compliant patients were excluded.Among the1916 patients included,general anesthesia patients accounted for 9.8%(n=188),and spinal anesthesia patients accounted for 90.2%(n=1728).Patients in the general anesthesia group and spinal anesthesia group had a downward trend in SBP after anesthesia,but the decline in the general anesthesia group was more obvious.The general anesthesia group and the spinal anesthesia group had statistically significant differences(p<0.05)in the incidence of ICU admission(22.38% vs 6.37%)and unplanned intubation(3.78% vs 0.12%).There were 9cases of unplanned intubation,the incidence was 0.47%,and 4 cases died,and the mortality rate was 0.21%.The results of binary logistic regression analysis showed that the method of anesthesia,the length of operation,age and diabetes were the risk factors for patients to be admitted to the ICU.Conclusion: The vital signs during spinal anesthesia with bupivacaine-fentanyl fine needles isobaric spinal anesthesia are more stable,which significantly reduces the occurrence of unplanned intubation and admission to the ICU after the operation.It can be safely used for elderly lower limb orthopedic surgery;anesthesia type,operation duration,age and diabetes are risk factors for patients to be admitted to the ICU.