全身麻醉联合神经阻滞应用于老年髋关节置换术后镇痛效果和对H-FABP、B-FABP的影响  

Analgesic Effect of General Anesthesia Combined with Nerve Block on H-FABP and B-FABP after Hip Replacement in Elderly Patients

作　　者：胡东初 陈月华 彭海宾 周天芸 HU Dongchu;CHEN Yuehua;PENG Haibin;ZHOU Tianyun(Department of Anesthesiology,Rongqiang Hospital,Fuqing 350300,China)

机构地区：[1]福建省福清融强医院麻醉科,福建福清350300

出　　处：《中国医药指南》2023年第22期113-115,共3页Guide of China Medicine

摘　　要：目的 研究全身麻醉联合神经阻滞应用于老年髋关节置换术后镇痛效果和对中心型脂肪酸结合蛋白(H-FABP)、脑型脂肪酸结合蛋白(B-FABP)的影响。方法 选择2018年10月至2022年8月于医院接受髋关节置换术的85例老年患者。以单双数字表法将其分为观察组42例及对照组43例。对照组开展单独全身麻醉处理,观察组则开展全身麻醉联合神经阻滞处理。分析两组术后镇痛情况,手术前后H-FABP、B-FABP水平,术后认知功能,不良反应发生情况等方面的差异。结果 观察组术后6 h、12 h、24 h时的NRS评分相较于对照组均更低(均P <0.05)。术后6 h观察组血清H-FABP、B-FABP水平相较于对照组均更低(均P <0.05)。术后1 d、术后3 d时观察组认知功能MMSE评分相较于对照组均更高(均P<0.05)。在不良反应总发生率方面对比,观察组低于对照组(P<0.05)。结论 全身麻醉联合神经阻滞应用于老年髋关节置换术后镇痛效果显著,可抑制H-FABP、B-FABP水平升高,降低不良反应发生风险。Objective To study the analgesic effects of general anesthesia combined with nerve block in elderly patients after hip replacement and to analyze the effects on central fatty acid binding protein(H-FABP)and brain fatty acid binding protein(B-FABP).Methods Eighty-five elderly patients who received hip arthroplasty in hospital from October 2018 to August 2022 were selected.They were divided into observation group(42 cases)and control group(43 cases)by the method of single and double digit table.The control group received general anesthesia alone,and the observation group received general anesthesia combined with nerve block.The postoperative analgesia,H-FABP and B-FABP levels before and after surgery,postoperative cognitive function,and the occurrence of adverse reactions were analyzed.Results The NRS scores of the observation group at 6 hours,12 hours and 24 hours,compared with the control group points were lower(all P<0.05).The serum H-FABP and B-FABP levels in the observation group,compared with the control group were lower(P<0.05).The MMSE scores of cognitive function in the observation group one day and three days after surgery,which were higher than those in the control group(all P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion General anesthesia combined with nerve block has significant analgesic effect after hip replacement in the elderly,which can inhibit the increase of H-FABP and B-FABP levels and reduce the risk of adverse reactions.

关 键 词：髋关节置换术 全身麻醉 神经阻滞 中心型脂肪酸结合蛋白 脑型脂肪酸结合蛋白 

分 类 号：R614[医药卫生—麻醉学]