Effects of different anesthesia methods on perioperative coagulation in unilateral lower extremity bone and joint surgery

Objective To explore the effects of general anesthesia,combined spinal-epidural anesthesia and epidural anesthesia on perioperative coagulation in unilateral lower extremity bone and joint surgery. Methods One hundred and eighty cases of unilateral lower extremity bone and joint surgery patients in the Taizhou Central Hospital from January,2012 to December,2016 were selected,and were divided into general anesthesia group,lumbar combined anesthesia group and epidural anesthesia group according to the random number method,each group was 60 cases.The VAS scores were performed at 6,24 and 48 h after operation.The coagulation function before anesthesia,6 h after anesthesia,24 h after operation were determined.The incidence of thrombotic complications during perioperative period was recorded. Results The VAS score at 6,24 and 48 h after operation of the combined spinal anesthesia group and the epidural anesthesia group were lower than that of the general anesthesia group(P<0.05) The VAS score at 6,24 and 48 h after operation of the combined spinal anesthesia group were lower than that in the epidural anesthesia group(P<0.05).The values of PT and TT in general anesthesia group,lumbar combined anesthesia group and epidural anesthesia group at 6 h after anesthesia,24 h after operation were significantly higher than those before anesthesia(P<0.05),the values of APTT at 6h after anesthesia were significantly higher than those before anesthesia(P<0.05),at 6 h after anesthesia,24 h after operation were significantly lower than those before anesthesia(P<0.05).The incidence of thrombotic complications in the combined spinal epidural anesthesia group and epidural anesthesia group were lower than that in the general anesthesia group(P<0.05). Conclusion The analgesic effect combined spinal epidural anesthesia and epidural anesthesia for unilateral lower extremity bone and joint surgery is good,and combined spinal epidural anesthesia and epidural anesthesia can improve the perioperative hypercoagulable state of blood,reduce the incidence of perioperative thrombotic complications,the effect of combined spinal epidural anesthesia is better.