Effects of Combined Spinal Epidural Anaesthesia and Spinal Anaesthesia on Peri-Operative Pulmonary Status in Geriatric Patients in Lower Extremity Surgery

作     者：Sharmin Ara Begum A. K. M. Akhtaruzzaman Dilip Kumar Bhowmick Debabrata Banik Md. Afzalur Rahman A. K. M. Shahidur Rahman Md. Saydur Rahman Khandoker Moynul Hasan Mohammad Kamrul Ahsan Md. Imrul Islam Muhammad Shamsul Arefin Tahmidul Islam Sharmin Ara Begum;A. K. M. Akhtaruzzaman;Dilip Kumar Bhowmick;Debabrata Banik;Md. Afzalur Rahman;A. K. M. Shahidur Rahman;Md. Saydur Rahman;Khandoker Moynul Hasan;Mohammad Kamrul Ahsan;Md. Imrul Islam;Muhammad Shamsul Arefin;Tahmidul Islam

作者机构：Department of Anaesthesiology National Institute of Traumatology and Orthopedic Rehabilitation (NITOR) Dhaka Bangladesh Department of Anaesthesia Analgesia and Intensive Care Medicine Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Neuro-Anaesthesia National Institute of Neurosciences and Hospital (NINS) Sher-e-Bangla Nagar Agargaon Dhaka Bangladesh Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Anaesthesia Asgor Ali Hospital Dhaka Bangladesh Department of Pediatric Surgery Shaheed Suhrawardy Medical College and Hospital Dhaka Bangladesh Holy Family Red Crescent Medical College Hospital (HFRCMCH) Dhaka Bangladesh Department of Anaesthesiology and Intensive Care Unit (ICU) Rajshahi Medical College Hospital (RMCH) Rajshahi Bangladesh Department of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh 

出 版 物：《Journal of Biosciences and Medicines》 (生物科学与医学（英文）)

年 卷 期：2020年第8卷第10期

页      面：132-147页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Combined Spinal Epidural Anaesthesia (CSEA) Geriatric Patients Spinal Anaesthesia (SA) 

摘      要：Background: Lower extremity surgeries performed in elderly people usually have high prevalence of peri-operative medical problems related to anaesthesia. The overall objective of peri-operative care of geriatric population is to fast recovery from anaesthesia and avoid functional decline. Objective: To compare the peri-operative pulmonary status of combined spinal epidural anaesthesia (CSEA) and spinal anaesthesia (SA) in geriatric patients underwent lower extremity surgeries. Methods: This prospective comparative study was conducted at Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2016 to June 2018. A total of 70 geriatric cases that underwent lower extremity surgeries were included in this study. Cases were randomly allocated into two groups;35 in Group A (CSEA) and 35 in Group B (SAB). The different outcome variables between the groups like-duration of anaesthesia, respiratory rates (RR), oxygen saturation (SpO2), end tidal CO2 (EtCO2), peak expiratory flow rate (PEFR), breath holding test (BHT), peri-operative side effects of anaesthesia and post-operative visual analogue score (VAS) were analyzed and compared by statistical tests. Results: The mean age, weight, BMI of Group A and Group B patients were not significantly different (p 0.05). No significant differences were observed in duration of surgery, gender and ASA grade between the groups (p 0.05). Mean duration of anaesthesia, mean time to achieve target level of sensory block and mean time to achieve complete motor block were significantly higher in Group A (p 2, PEFR and BHT of both groups were not significantly different (p 0.05). Peri-operative side effects of anaesthesia and post-operative VAS were significantly less in group A patients (p