超声引导下臂丛神经阻滞麻醉对老年桡骨远端粉碎性骨折患者麻醉效果及认知功能的影响  

Influences of ultrasound-guided brachial plexus block anesthesia on anesthesia effect and cognitive function in elderly patients with comminuted distal radius fractures

作　　者：黎伟 刘林芝 LI Wei;LIU Linzhi(Anesthesiology Department,Chang'an Hospital,Xi'an 710016,China)

机构地区：[1]长安医院麻醉科,陕西西安710016

出　　处：《临床医学研究与实践》2023年第32期81-84,共4页Clinical Research and Practice

摘　　要：目的探讨超声引导下臂丛神经阻滞麻醉对老年桡骨远端粉碎性骨折患者麻醉效果及认知功能的影响。方法选取2020年10月至2022年10月我科收治的300例老年桡骨远端粉碎性骨折患者为研究对象,按照随机数字表法将其分为对照组(常规解剖定位法臂丛神经阻滞麻醉)和观察组(超声引导下臂丛神经阻滞麻醉),各150例。比较两组的麻醉效果。结果观察组的麻醉用药剂量少于对照组,阻滞起效时间、麻醉完成时间短于对照组,镇痛维持时间长于对照组,差异具有统计学意义(P<0.05)。入室后(T_(0))、术毕时(T_(4)),两组的5-羟色胺(5-HT)、前列腺素E_(2)(PGE_(2))水平比较,差异无统计学意义(P>0.05);神经阻滞时(T_(1))、神经阻滞5 min后(T_(2))、手术30 min时(T_(3)),观察组的5-HT、PGE_(2)水平低于对照组,差异具有统计学意义(P<0.05)。术后1 d,观察组的简易精神状态评估量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分高于对照组,差异具有统计学意义(P<0.05)。术后1 d,观察组的神经元特异性烯醇化酶(NSE)水平低于对照组,神经生长因子(NGF)水平高于对照组,差异具有统计学意义(P<0.05)。结论超声引导下臂丛神经阻滞麻醉能提高老年桡骨远端粉碎性骨折患者的麻醉效果,减轻术中机体疼痛应激反应,也能减轻对术后认知功能的影响,值得推广。Objective To explore the influences of ultrasound-guided brachial plexus block anesthesia on anesthetic effect and cognitive function of elderly patients with comminuted distal radius fractures.Methods A total of 300 elderly patients with comminuted distal radius fractures admitted in our department from October 2020 to October 2022 were selected as the research objects.According to the random number table method,the patients were divided into control group(brachial plexus block anesthesia with conventional anatomical positioning method)and observation group(ultrasound-guided brachial plexus block anesthesia),with 150 cases in each group.The anesthesia effects of the two groups were compared.Results The dose of anesthesia in the observation group was less than that in the control group,the onset time of block and the completion time of anesthesia were shorter than those in the control group,and the duration of analgesia was longer than that in the control group,and the differences were statistically significant(P<0.05).After entering the operating room(T_(0))and at the end of operation(T_(4)),there were no significant differences in the levels of 5-hydroxytryptamine(5-HT)and prostaglandin E_(2)(PGE_(2))between the two groups(P>0.05);at the time of nerve block(T_(1)),5 min after nerve block(T2)and 30 min after operation(T_(3)),the levels of 5-HT and PGE_(2) in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 1 d after surgery,the scores of Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).At 1 d after surgery,the level of neuron-specific enolase(NSE)in the observation group was lower than that in the control group,and the level of nerve growth factor(NGF)was higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Ultrasound-guided brachi

关 键 词：超声引导 臂丛神经阻滞 桡骨远端粉碎性骨折 麻醉 认知功能 

分 类 号：R614[医药卫生—麻醉学]