Analgesic Effect of Combined Spinal-Epidural Anesthesia and its Effect on TNF-α and CRP Levels in Elderly Patients with Hip Fracture During Surgical Treatment

Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.

Clinical Efficacy of Acupuncture on the Morphine-related Side Effects in Patients Undergoing Spinal-epidural Anesthesia and Analgesia

Objective： To investigate the effects of acupuncture on the morphine-related side effects （nausea, vomiting, itchiness and gastrointestinal disorders） in patients undergoing anesthesia and analgesia and try to find the clinical mechanism of acupuncture. Methods： Patients scheduled to have transurethral prostatic resection enrolled in the study （69 patients）, characterized as Grade Ⅱ or Ⅲ by the American Society of Anesthesiologists physical status classification, were randomly assigned to three groups, 23 patients in each group： the placebo group （control group）, non-anesthesia area （NAA） group, and the anesthesia area （AA） group. After spinal anesthesia, all patients received Patients Controlled Epidural Analgesia. The vital signs, bowel sounds, visual analogue scales, itchiness, nausea and vomiting, and time for first exhaust post operation were observed. Results： Altogether, nine cases were eliminated, three in each group. Finally, sixty cases completed this study, twenty in each group. There was a significant decrease of bowel sounds after morphine spinal anesthesia in the three groups. Compared with the control or AA group, the bowel sound recovered after acupuncture, the incidences of nausea and vomiting, itchiness, and time for first exhaust after operation decreased in the NAA group （P〈0.05）. There was a significant decrease of the incidence for itchiness in the NAA group compared with the control group （P〈0.05）. Conclusions： On the basis of this study, it is obviously seen that acupuncture could decrease the incidence of morphine-related side effects （nausea and vomiting, itchiness and gastrointestinal disorders） when the spinal cord conduct is normal. However, it decreases only the incidence of itchiness but not for gastrointestinal dysfunction when the spinal cord is blocked.