Abstract: Objective To observe the effect of mediators of inflammation and stress hormone on elder patients with continuous spinal anesthesia through the Spinocath pipe during the extremitas inferior operation. Methods 56 elder patients aged 62 to 80 with ASAⅠ~II with extremitas inferior operation were divided by random digits table into two groups: A group (continuous spinal anesthesia group :28) and B group (combined spinal and epidural anesthesia group:28). A group with continuous spinal anesthesia were piqured through L3-4 , inserted the Spinocath pipe 2 to 3 cm into the subarachnoid space and given the loading dose of 0.75% Ropivacaine 0.5 to 1ml. B group with combined spinal and epidural anesthesia were piqured through L2-3 or L3-4 , inserted the pipe 3 to 5 cm cephalad into the epidural space and given the dose of 0.75% Ropivacaine 1.5 to 2ml into the subarachnoid space . The results of MAP, CO, SVR, and ACI were determined at the time of before anesthetizing(T0), 5 minutes after anesthesia(T1), 10 minutes(T2), 30 minutes(T3) , 1 hour after anesthesia(T4) and operation ending (T5)with digital noninvasive blood flow power monitoring system. The blood of peripheral vein were collected at the time of T0, T1,T2,T3,T4 and T5 , the results of IL-1, IL-6 and TNF-α were determined at the same time with enzyme-labeled immunosorbent assay and the results of blood glucose and hydrocortisone were also determined at the same time with flow cytometry .Results Compared to the results before anesthetizing, the results of MAP, CO, SVR and ACI in group A were descended but no statistically significant at all the time points(P>0.05); Compared to group A and the results before anesthetizing, the results of MAP, CO, SVR and ACI in group B were obviously descended which had the most significant haemodynamic changes during the time stage T1 to T3 (P<0.05). Compared to the results before anesthetizing, the results of blood glucose and hydrocortisone in group A were gradually heightened but slightly which had no statistically significant (P>0.05). Compared to group A and the results before anesthetizing, the results of blood glucose and hydrocortisone in group B were increased which had the statistical significance (P<0.05), which had the significant statistical significance during the time stage T3 to T5 (P<0.01). Compared to the results before anesthetizing, the results of IL-1, IL-6 and TNF-αin group A were heightened but descended at the time of operation ending which had no statistically significant (P>0.05) ; Compared to group A and the results before anesthetizing, the results of IL-1, IL-6 and TNF-αin group B were rapidly heightened which had significant statistical significance but diminished during the time stage T3 to T5 (P<0.01).Conclusions Compared to combined spinal and epidural anesthesia, continuous spinal anesthesia was a better suitable method of anesthesia way which had the stabilize hemodynamics and could restrain the changes of mediators of inflammation and stress hormone on elder patients with extremitas inferior operation.
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