Effects of general anesthesia and epidural anesthesia on coagulation function during total knee replacement in the elderly

doi:10.3969/j.issn.2095-4344.2015.35.007

Abstract

Abstract:

BACKGROUND: In perioperative period of total knee replacement in elderly patients, it is crucial to maintain the normal function of blood coagulation. However, many factors may influence coagulation function of patients in perioperative period. Of them, anesthesia is an important factor. Different anesthesia methods will produce different effects on blood coagulation. Appropriate anesthesia methods should be selected in the clinic to maintain the stability of coagulation function.
OBJECTIVE: To explore the effect of application of general anesthesia and epidural anesthesia in elderly knee replacement and the effects on the function of blood coagulation.
METHODS: A retrospective analysis was performed on clinical data of 135 elderly patients after total knee replacement in Dongying Hospital of Shandong Provincial Hospital Group from September 2012 to September 2013. All patients were divided into control group (67 cases; general anesthesia) and observation group (68 cases; epidural anesthesia) according to the mode of anesthesia. Coagulation indexes and D-dimer levels were
observed before anesthesia, 6 hours after anesthesia, and 1 day after replacement in both groups. The incidence of deep venous thrombosis was measured and compared between the two groups in 12-month follow-up.
RESULTS AND CONCLUSION: Through the statistics and comparison, no significant difference was detected in blood coagulation indexes at different time points in the two groups (all P > 0.05). However, significant differences in D-dimer levels were detectable between the two groups at 6 hours after anesthesia and in the morning at 1 day after replacement. D-dimer levels were significantly lower in the observation group than in the control group (all P < 0.05). The incidences of deep venous thrombosis were 3% and 21% in the observation and control groups, respectively, showing significant differences (P < 0.05). These results suggest that epidural anesthesia during elderly totak knee replacement obtained good effects, and could maintain stable coagulation function.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Anesthesia, General, Anesthesia, Epidural, Venous Thrombosis

CLC Number:

R318

Ma Hua-shan, Liu Jin-shan, Tian Ling, Dong Chuan-zhen, Chen Li-yong. Effects of general anesthesia and epidural anesthesia on coagulation function during total knee replacement in the elderly [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(35): 5610-5614.

Figures/Tables 4

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