Clinical Study Of PFNA In The Treatment Of Intertrochanteric Fractures Of Femur Under General Anesthesia And Intraspinal Anesthesia

Objective: To investigate the effects of general anesthesia and intraspinal anesthesia on the hospitalization costs,blood loss,postoperative complications and postoperative mortality at 30 days of Femoral intertrochanteric fractures treated with PFNA(Proximal Femoral Nail Antirotation),so as to provide reference for the selection of anesthesia methods for the clinical treatment of patients with Femoral intertrochanteric fractures.Methods: Clinical data of 231 patients aged ?65 years who were hospitalized in guangzhou Red Cross hospital from December 2014 to August 2018 were retrospectively analyzed.They were divided into general anesthesia group(182 cases)and intraspinal anesthesia group(49 cases)according to different anesthesia methods.Age,gender,preoperative basic diseases,ASA classification,Jensen-Evans classification of fracture,hospitalization expenses,anesthesia expenses,intraoperative blood loss,intraoperative blood transfusion expenses,hospitalization days,anesthesia time,operation time,preoperative and postoperative hemoglobin and albumin contents and their differences,postoperative complications and postoperative mortality at 30 days were collected.SPSS20.0 statistical software was used to analyze the above indexes.Results:A total of 231 patients were statistically analyzed.There were no statistically significant differences in age,gender,preoperative basic disease,ASA classification and Jensen-Evans classification of fracture between the two groups(P>0.05).The hospitalization cost of the intraspinal anesthesia group was(46394.97± 7523.76)yuan,which was lower than that of the general anesthesia group(49450.25± 3262.35)yuan,and the difference was statistically significant(P<0.05).The cost of anesthesia in the intraspinal anesthesia group was(6302.60±849.41)yuan,which was lower than thatin the general anesthesia group(8977.80±1093.20)yuan,and the difference between the two groups was statistically significant(P<0.05).Intraoperative blood loss of 100(100,150)ml in the intraspinal anesthesia group was lower than that of 200(100,200)ml in the general anesthesia group,and the difference between the two groups was statistically significant(P<0.05).Intraoperative blood transfusion cost in the intraspinal anesthesia group was 420 yuan(215,420),which was the same as that in the general anesthesia group,and the difference between the two groups was statistically significant(P<0.05).In addition,the postoperative transfusion rate(12.2%)in the intraspinal anesthesia group was lower than that in the general anesthesia group(25.8%),with statistically significant difference(P<0.05).There were no significant differences in length of stay,duration of anesthesia,duration of operation,preoperative and postoperative hemoglobin and albumin content and their differences,postoperative complications and postoperative mortality at 30 days between the two groups(P>0.05).Conclusion: There was no difference in the effect of postoperative complications and30-day mortality rate on general anesthesia and intraspinal anesthesia,but compared with general anesthesia,the patients with intraspinal anesthesia can reduce hospitalization cost,cost of anesthesia,intraoperative blood transfusion,intraoperative blood loss and postoperative blood transfusion rate,in PFNA treatment of intertrochanteric fracture patients,suggest preferred intraspinal anesthesia.