Effects of General Anesthesia with Laryngeal Mask Airway Combined with Epidural Anesthesia on Stress Reaction of Elderly Patients Undergoing Total Hip Replacement

Objective To evaluate the efficacy of general anesthesia(GA) with laryngeal mask airway(LMA) combined with epidural anesthesia on the stress reaction of elderly patients undergoing total hip replacement.Methods A total of 80 elderly patients(65-85 years) scheduled for selective total hip replacement were randomly divided into four groups:A(GA with tracheal intubation),B(GA with tracheal intubation and epidural anesthesia),C(GA with LMA) and D(GA with LMA and epidural anesthesia).The changes of MAP and HR were recorded at baseline(T_0),immediately after LMA insertion or intubation(T_1),detaching periosteum(T_2),immediately before LMA withdrawal or extubation(T_3) and 3 min after LMA withdrawal or extubation(T_4).Blood specimens were taken at T_0-T_4 for determine of plasma concentration of epinephrine(E) and norepinephrine(NE).Results MAP,HR,NE and E in groups A and B were significantly higher at T_1,T_3 and T_4 than those at T_0(P0.05),in groups A and C were significantly higher at T_2 than the other groups(P0.05).There was no significant difference in MAP,HR,NE and E in group D at T_1-T_4.Conclusion GA with LMA combined with epidural anesthesia in the elderly patients undergoing total hip replacement can maintain a stable hemodynamics and effectively reduce the stress reaction.