Elderly patients with lower extremity fractures on the Anesthesia.docVIP

 PAGE \* MERGEFORMAT 6 Elderly patients with lower extremity fractures on the Anesthesia Our hospital has 60 patients over the age of 80 surgical patients in lower limb fracture surgery, including total hip replacement in 23 cases, 17 cases of femoral head replacement, femoral fractures with open reduction and internal fixation in 20 cases. Now some of our Anesthesia reported below. 1 Clinical data 60 cases of elderly patients aged 80 to 95 years, including 22 male and 38 female, the condition rating of 3 to 4. Preoperative ECG, 26 patients had abnormal electrocardiogram: myocardial ischemia in 26 cases, 4 cases of myocardial infarction history , 4 cases of atrioventricular block, right bundle branch block in 6 cases, left bundle branch block in 2 cases, 24 patients had chronic bronchitis and emphysema, 32 patients had hypertension, coronary heart disease, 4 cases, severe anemia, 6 cases of deafness, 16 cases of dementia, 1 case of severe scoliosis spinal deformity associated with chronic pneumonia, her family requested a risky surgery. preoperative routine complete examination, preoperative hemoglobin were lower and prepare appropriate corrective surgery using blood. anesthetic routine intramuscular injection of the first half hour has Kui ether hydrochloride 0.5 ~ 1mg, luminal 0.1g. burglary after the first establishment of intravenous access, give hydroxyethyl starch injection 500ml expansion, the line of radial artery puncture, puncture of internal jugular vein access pressure transducer pressure measurement, routine ECG monitoring of blood pressure, central venous pressure, electrocardiogram, oxygen saturation, heart rate, conventional oxygen mask. The group of 60 patients were selected for lumbar epidural puncture L2 ~ 3 or L3 ~ 4 intervertebral space, the success of 0.5% bupivacaine injection after 1.5 ~ 2.5ml, pull out the spinal needle, epidural catheter inserted up about 3cm, the control block level T10 below, the exact effect of anesthesi