Experience of application of general anesthesia with OPLAC laryngeal mask airway combined continuous epidural anesthesia for high-risk elderly patients in lower abdominal and lower limb surgery

Objective:To investigate the effects of general anesthesia with OPLAC laryngeal mask airway(LMA)ventilation combined continuous epidural anesthesia for high-risk elderly patients in lower abdominal and lower limb surgery.Methods:50 patients were randomly divided into two groups(n = 25):combined anesthesia group(Group A),intravenous anesthesia group(Group B).Patients in group A were administrated abdominal epidural block up to T10 induced with 0.33% ropivacaine( 5 ml · h-1);general anesthesia with OPLAC LMA were induced with midazolam(0.04 mg·kg-1),fentanyl(2-6 μg·kg-1),propofol(1-1.5 mg·kg-1) and atracurium(0.1 mg·kg-1) intravenously and maintained with propofol(50-100 μg·kg-1·min-1) and remifentanil(0.05-0.5 μg·kg-1·min-1),while patients in group B were induced using the same drugs in the same procedures and maintained with propofol( 60-120 μg · kg-1·min-1) and remifentanil(0.05-1 μg·kg-1·min-1).Hemodynamic parameters of MAP,HR,SpO2at time of before induction( T0),after induction(T1),intubation(T2),5 minutes after intubation(T3),extubation(T4);Anesthetic drug dosage,awake time,extubation time,recovery scale( Steward),and incidence of postoperative complications such as nausea,vomiting were recoded.Results:Compared with group B,the time of awake and extubation in group A were significantly decreased(P 0.05),and recovery scale were significantly increased(P 0.05).Compared with group B,the stability of MAP),HR,SpO2in group A were significantly increased(P 0.05),while anesthetic drug dosage significantly decreased(P 0.05).Compared with group B,the incidence of postoperative complications in group A were significantly decreased(P 0.05).Conclusion:General anesthesia combined continuous epidural anesthesia results in less anesthetic drug dosage and earlier recovery of respiratory function and consciousness than conventional general anesthesia with OPLAC laryngeal mask airway,and reduce the risk for the incidence of postoperative complications.