Effect of combined spinal-epidural anesthesia versus general anesthesia on hemodynamics and stress response in patients with hip replacement

Objective To compare the effect of combined spinal-epidural anesthesia and general anesthesia on hemodynamics and stress response in patients with hip replacement. Methods Totally 120 patients with hip replacement were divided into two groups according to anesthesia plan. The patients in the combined spinal-epidural anesthesia group(n=54)and the general anesthesia group(n=66)were treated with combined spinal-epidural anesthesia and general anesthesia by tracheal intubation, respectively. The heart rate, oxygen saturation and mean arterial pressure at time points of 15 minutes before anesthesia(T₁), 30 minutes after anesthesia(T₂)and the end of operation(T₃)were compared between the two groups. The levels of serum cortisol and catecholamine at different time points were compared between two groups, and the incidence of adverse reactions was compared between two groups. Results The heart rate and mean arterial pressure at T₂ decreased significantly and increased significantly at T₃ in both groups(P<0.05), and the oxygen saturation at T₃ in the general anesthesia group decreased significantly, and was significantly lower than the combined spinal-epidural anesthesia group(P<0.05). The levels of serum cortisol and catecholamine at T₂ significantly increased in both groups, and those in the combined spinal-epidural anesthesia group were significantly higher than that of the general anesthesia group(P<0.05). The levels of serum cortisol and catecholamine at T₃ significantly reduced in both groups, but there were no significant differences - between the two groups(P>0.05). The incidence of adverse reactions in the combined spinal-epidural group was 5.56%, which showed no significant difference when compared to 22.73% in the general anesthesia group(P<0.05). Conclusion Compared with general anesthesia, combined spinal-epidural anesthesia can maintain stable intra-operative hemodynamics, relieve the stress response in hip replacement and reduce the incidence of adverse reactions.