To Evaluate the effectiveness and safety of neuroaxial anesthesia for lower limb joint replacement in elderly and senile patients with a high comorbidity index and ASA class III and IV physical status.
Materials and Methods: The studies were carried out in a multidisciplinary TMA clinic in 40 geriatric patients with a comorbid background who were operated on under conditions of combined spinal-epidural anesthesia. 29 patients underwent total hip arthroplasty (THA), 11 - total knee arthroplasty (TKA). Inclusion criteria: elderly (65 to 75 years) and senile (76-90 years) age, and over 90 - long-livers, pain syndrome for more than one year, no contraindications for regional methods of anesthesia. For continuous monitoring of the vital functions of the patient, we used the "resuscitation-surgical" monitor YUM 300 (LLC "Company UTAS" Ukraine).
Conclusion: For elderly and senile patients with a high risk of comorbidity, the technique of unilateral spinal and epidural anesthesia with low doses of intrathecal local anesthetic (5 mg 0.5% hyperbaric solution of bupivacaine with 20 μg fentanyl) and additional administration of low doses of bupivacaine into the epidural space 7, 5 mg is a safe method of anesthesia and allows you to achieve the proper sensory - motor block, which is necessary for the replacement of the joints of the lower extremities.
Purpose: to determine the effect of unilateral spinal anesthesia on systemic and central hemodynamics, to identify its side effects in the elderly and senile, with total hip replacement.
Materials and methods: 60 patients of geriatric age operated on under unilateral spinal anesthesia were examined. 44 patients underwent total hip arthroplasty (THA), 16 - total knee arthroplasty (TKA). Inclusion criteria: elderly (from 60 to 75 years). For continuous monitoring of the vital functions of the patient, they used the "resuscitation and surgical" monitor UM 300 (LLC UTAS Company Ukraine).
Conclusion: Unilateral spinal anesthesia is a safe and highly effective technique that can provide full intraoperative pain management for patients with total hip replacement in a high-risk group of patients.
Objective: To evaluate the efficacy and safety of patient-controlled analgesia through prolonged epidural analgesia after joint replacement of the lower extremities.
Material and methods. We analyzed the postoperative period of 213 elderly and senile patients who were operated on for degenerative-dystrophic and traumatic injuries of the joints of the lower extremities. All patients underwent total joint replacement (164 - THA and 49 - TKA). The age of patients is from 65 to 90 years (average age was 78 ± 8 years) with a physical status of ASA 3 and above. All examined patients were divided into 2 groups. 63 patients comprised the main group, which in the postoperative period underwent patient-controlled analgesia (PCA) through prolonged epidural analgesia. The control group consisted of 150 patients, for the anesthesia of which in the postoperative period only standard systemic multimodal analgesia was used
Conclusion. Patient-controlled analgesia is an alternative to traditional analgesic regimens. This method should be one of the main methods after surgical anesthesia for joint replacement of the lower limb in elderly and senile patients.