Volume 21 Issue 1
Jan.  2023
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ZHANG Jia, YANG Bao-zhong, GUAN Xiao-dong. Implementation of ERAS anaesthesia management measures in elderly patients undergoing total hip replacement[J]. Chinese Journal of General Practice, 2023, 21(1): 62-65. doi: 10.16766/j.cnki.issn.1674-4152.002812
Citation: ZHANG Jia, YANG Bao-zhong, GUAN Xiao-dong. Implementation of ERAS anaesthesia management measures in elderly patients undergoing total hip replacement[J]. Chinese Journal of General Practice, 2023, 21(1): 62-65. doi: 10.16766/j.cnki.issn.1674-4152.002812
shu

Implementation of ERAS anaesthesia management measures in elderly patients undergoing total hip replacement

doi: 10.16766/j.cnki.issn.1674-4152.002812
  • 1.

    College of Anesthesiology, Shanxi Medical University, Taiyuan, Shanxi 030600, China

Funds:

 2020TD22

  • Received Date: 2022-07-22
    Available Online: 2023-04-07
    Abstract
  •   Objective  This study aimed to observe the clinical effect of enhanced recovery after surgery (ERAS) anaesthesia management in the perioperative period of total hip arthroplasty in the elderly patients.  Methods  A total of 120 elderly patients who underwent elective total hip arthroplasty in Yuncheng Central Hospital from October 2019 to October 2021 were selected as the study subjects. They were randomly divided into the control group (60 cases) and study group (60 cases). The control group performed total hip arthroplasty under general anaesthesia, and the study group performed ERAS anaesthesia management measures. The control group received total hip arthroplasty under general anaesthesia, and the study group received ERAS anaesthesia management measures. The recovery indexes after operation and anaesthesia was recorded. The changes in VAS score and contents of serum inflammatory and stress factors such as tumor necrosis factor-α (TNF-α), inflammatory factors interleukin-6 (IL-6), norepinephrine (NE) and cortisol (Cor) were compared within 48 h after operation. The number of remedial analgesia and adverse reactions of analgesic drugs within 48 h after operation were counted, and the complications during hospitalisation were observed.  Results  The intraoperative bleeding volume in the study group [(1 022.86±26.74) mL] was less than that in control group [(1 350.41±28.29) mL, t=65.177, P < 0.001]. The recovery time of postoperative spontaneous breathing, anaesthesia awakening time, extubation time, postoperative first exhaust time, postoperative ambulation time and hospitalization time of the study group were shorter than those of the control group (all P < 0.05). The VAS scores of the study group were lower than those of the control group at 12, 24, 36 and 48 h after operation (all P < 0.05). At 24 and 48 h after operation, the content of serum TNF-α, IL-6, NE and Cor in the study group was lower than that in the control group (all P < 0.05). The rate of remedial analgesia, adverse reaction of analgesic drugs and postoperative complications in the study group was significantly lower than that in the control group (all P < 0.05).  Conclusion  ERAS anaesthesia management mode can effectively reduce the surgical trauma of total hip replacement in the elderly, inhibit stress and inflammatory reaction, alleviate postoperative pain reaction, shorten the rehabilitation cycle and reduce the risk of adverse drug reactions and complications.

     

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