Effectiveness and safety of oxycodone combined with intraspinal anesthesia for femoral neck fracture surgery in elderly patients

ObjectiveTo analyze the effectiveness and safety of oxycodone combined with intraspinal anesthesia for femoral neck fracture surgery in elderly patients.

MethodsForty patients with femoral neck fracture were divided into the general anesthesia group(group C, n=21), and oxycodone combined with subarachnoid anesthesia group(group O, n=19) according to the anesthesia program.The hemodynamic parametersheart rate(HR), mean arterial pressure(MAP), blood oxygen saturation(SpO₂), stress indexescortisol(Cor), norepinephrine(NE) and angiotensin Ⅱ(Ang Ⅱ) before anesthesia(T0), after anesthesia(T1) and during suture(T3) were compared between two groups.The visual analogue score(VAS) before and after operation were compared between two groups, and the occurrence of complications were recorded.

ResultsAt T0, there was no statistical significance in the levels of HR, MAP and SpO₂ between two groups(P>0.05).At T1 and T2, the levels of HR and MAP in two groups were significantly lower than those at T0(P < 0.01), while the levels of HR and MAP at T1 and MAP level at T1 in group O were higher than those in group C(P < 0.05 to P < 0.01).At T0, there was no statistical significance in the levels of Cor, NE and Ang Ⅱ between two groups(P>0.05).At T1 and T2, the serum levels of Cor, NE and Ang Ⅱ in two groups significantly increased compared with at T0, while the levels of Cor, NE and Ang Ⅱ in group O at T1 and T2 were significantly lower than those in group C(P < 0.01).There was no statistical significance in VAS score between two groups before operation(P>0.05).After 6 h of surgery, the VAS scores in two groups were significantly lower than those before operation(P < 0.01), and the VAS score in group O was significantly lower than that in group C(P < 0.01).The incidence rates of nausea and vomiting in group O were lower than those in group C(P < 0.05), and there was no statistical significance in the incidence rates of pulmonary infection, incision infection and lower limb venous thrombosis between two groups(P>0.05).

ConclusionsCompared with conventional intravenous general anesthesia, the oxycodone combined with subarachnoid anesthesia is more advantageous in reducing circulatory fluctuation and general stress injury, enhancing postoperative analgesia, and reducing postoperative complications in elderly patients with femoral neck fracture surgery.