| Objective To explore the effects of different anesthesia techniques on the early prognosis of elderly patients undergoing total knee arthroplasty. Methods The data of patients who underwent elective unilateral total knee arthroplasty in the Department of Orthopedics of our hospital from October 2018 to September 2021 were analyzed. The patients were categorized into four groups based on the anesthetic methods: general anesthesia group (GA group), compound anesthesia group (CA group), peripheral nerve block group (PNB group), and spinal anesthesia group (SA group). The patients in the PNB and SA groups had a higher incidence of comorbidities and ASA classification than in the GA and CA groups. Patients' general information, operation time, anesthesia time, PACU observation time, and postoperative hospitalization days were recorded. The incidence of hypotension, vasoactive drug administration, postoperative remedial analgesia within 24 h, sufentanil dosage, postoperative inflammatory parameters, and the incidence of complications within 48 h were also recorded. Results The patients in the PNB group and SA group had a lower incidence of hypotension, lower rates of hypoxemia, less use of vasoactive agents, and lower incidence of acute myocardial injury, postoperative delirium, postoperative nausea and vomiting (PONV), lower rate of postoperative remedial analgesia, and lower rate of ICU admission (P＜0.05). PNB group and SA group also had a lower sufentanil dosage, lower leukocytes and C-reactive protein level (P＜0.05). Shorter postoperative PACU observation time and postoperative hospitalization time, with statistically significant differences were observed in two groups (P＜0.05). The sufentamil dosage, incidence of intraoperative hypotension, vasoactive agents usage and rate of postoperative remedial analgesia were significantly reduced as compared with GA group (P＜0.05). Conclusion Compared with general and combined anesthesia, peripheral nerve block and spinal anesthesia are recommended as anesthetic techniques for total knee arthroplasty in elderly patients to improve early prognosis. |
