The patient is elderly, underweight, and has femoral intertrochanteric bone. He had a history of surgery. During the preoperative visit, he was found to be apathetic and unable to cooperate with coughing. Coughing and sputum, electrocardiogram is normal, chest X-ray shows that the lower tongue segment of the left lung is small. There was a lot of inflammation. Echocardiography showed that the left atrium was slightly enlarged and the aortic valve was slightly closed. Insufficiency, mild to moderate tricuspid regurgitation, and ASA classification of III. technique Preliminary assessment should focus on the patient’s cardiopulmonary function and airway management difficulty. and general condition.

In view of the patient's advanced age and high ASA classification, general anesthesia The risk of intoxication is high, so it is recommended to consider neuraxial anesthesia, such as lumbar epidural Anesthesia or lumbar anesthesia. This approach can reduce the use of general anesthetic drugs The use has little impact on cardiopulmonary function.

If neuraxial anesthesia is chosen, local anesthesia may be used Intoxicants such as bupivacaine or ropivacaine are used for induction and maintenance. Ruoquan If general anesthesia is unavoidable, you should choose one that has less impact on cardiopulmonary function. Drugs, such as propofol, remifentanil, etc.

Since the patient has cardiopulmonary function problems, close attention should be paid during the operation Monitor vital signs such as electrocardiogram, blood pressure, and pulse oxygen saturation. Can Consider using bispectral index (BIS) monitoring to assess depth of anesthesia Spend.

Multimodal analgesia may be used postoperatively, including spinal Internal administration (such as epidural analgesia), Intravenous analgesia (such as opioids and non-steroidal anti-inflammatory drugs) and nerve blocks, etc.