术前与术后髂筋膜间隙阻滞镇痛对老年髋关节置换术患者术后认知功能的影响比较  

Comparison of preoperative and postoperative iliac fascia space block analgesia on postoperative cognitive function in elderly patients undergoing hip arthroplasty

作　　者：陆颖[1] 孙建明[1] 严三萍[1] 朱焱林[1] Lu Ying;Sun Jianming;Yan Sanping;Zhu Yanlin(Department of Anesthesiology,the People's Hospital of Jingjiang City,Jiangsu Jingjiang 214500)

机构地区：[1]靖江市人民医院麻醉科,江苏靖江214500

出　　处：《中国社区医师》2021年第33期46-47,共2页Chinese Community Doctors

摘　　要：目的:探讨术前与术后髂筋膜间隙阻滞镇痛对老年髋关节置换术患者术后认知功能的影响。方法:2019年11月-2020年7月收治行髂筋膜间隙阻滞镇痛的老年髋关节置换手术患者80例,依据镇痛时机不同分为两组,各40例。试验组术前镇痛,对照组术后镇痛,比较两组患者认知功能(MMSE量表)及术后认知功能障碍(POCD)发生率。结果:试验组术中瑞芬太尼维持用药量低于对照组,差异有统计学意义(P<0.05);试验组T1~T4时点MMSE量表评分均高于对照组,差异有统计学意义(P<0.05);试验组POCD发生率低于对照组,且均为轻症,差异有统计学意义(P<0.05)。结论:老年髋关节置换手术行术前髂筋膜间隙阻滞,对预防和减少老年人术后早期认知功能障碍具有积极作用。Objective:To explore the effect of preoperative and postoperative iliac fascia space block analgesia on postoperative cognitive function in elderly patients undergoing hip arthroplasty.Methods:From November 2019 to July 2020,80 elderly patients undergoing hip arthroplasty with iliac fascia space block analgesia were selected.According to the timing of analgesia,they were divided into two groups with 40 cases in each group.Preoperative analgesia was used in the experimental group.The control group was treated with postoperative analgesia.The cognitive function(MMSE scale)and the incidence of POCD were compared between the two groups.Results:The intraoperative maintenance dose of remifentanil in the experimental group was lower than that in the control group,the difference was statistically significant(P<0.05).In the experimental group,the scores of MMSE scale at T1 to T4 time points were higher than those in the control group,the difference was statistically significant(P<0.05).The incidence of POCD in the experimental group was lower than that in the control group,and all of them are mild,the difference was statistically significant(P<0.05).Conclusion:In the elderly hip arthroplasty,preoperative iliac fascia space block plays a positive role in preventing and reducing early postoperative cognitive impairment in the elderly.

关 键 词：老年 髋关节置换术 髂筋膜间隙阻滞 镇痛时机 认知功能 

分 类 号：R614[医药卫生—麻醉学]