超声引导下外周神经阻滞麻醉对老年患者下肢骨科手术后认知功能恢复的影响评价  

Evaluation of the Effect of Ultrasound-guided Peripheral Nerve Block Anesthesia on the Recovery of Cognitive Function after Lower Extremity Operation in the Elderly

作　　者：崔晓 CUI Xiao(Department of Anesthesiology,Xiamen Humanity Hospital,Xiamen,Fujian,361100,China)

机构地区：[1]厦门弘爱医院麻醉科,福建厦门361100

出　　处：《中外医疗》2024年第29期29-32,共4页China & Foreign Medical Treatment

摘　　要：目的探究超声引导下外周神经阻滞麻醉(peripheral nerve block,PNB)对老年患者下肢骨科手术后认知功能恢复的影响。方法随机选取2020年1月—2023年10月在厦门弘爱医院行下肢髋关节置换术的100例老年患者为研究对象,根据不同麻醉方法分为对照组和观察组,各50例,对照组行腰硬联合麻醉,观察组行超声引导下PNB麻醉。对比两组的基础体征变化、痛觉阻滞起效时间、认知功能及安全性。结果观察组在麻醉后10 min、术毕即刻的基础体征指标均高于对照组,差异有统计学意义(P均<0.05)。观察组痛觉阻滞起效时间长于对照组,差异有统计学意义(P<0.05)。观察组术后6 h、12 h的认知功能评分均高于对照组,差异有统计学意义(P均<0.05)。两组不良反应总发生率比较[4.00%(2/50)vs 8.00%(4/50)],差异无统计学意义(χ^(2)=0.177,P=0.673)。结论超声引导下PNB的痛觉阻滞起效时间较长,但能够更稳定维持老年下肢骨科手术患者的基础体征,加快术后认知功能恢复,并保障麻醉安全性。Objective To explore the effect of ultrasound-guided peripheral nerve block(PNB)on the recovery of cog⁃nitive function after lower extremity orthopedic surgery in the elderly.Methods A total of 100 elderly patients who un⁃derwent lower limb hip replacement in Xiamen Humanity Hospital from January 2020 to October 2023 were randomly selected as the research objects.According to different anesthesia methods,they were divided into control group and observation group,with 50 cases in each group.The control group received combined spinal-epidural anesthesia,and the observation group received ultrasound-guided PNB.The changes of basic signs,onset time of pain block,cognitive function and safety were compared between the two groups.Results The basic signs of 10 min after anesthesia and im⁃mediately after operation in the observation group were higher than those in the control group,and the differences were statistically significant(both P<0.05).The onset time of pain block in the observation group was longer than that in the control group,and the difference was statistically significant(P<0.05).The cognitive function scores of the ob⁃servation group at 6 h and 12 h after operation were higher than those of the control group,and the differences were statistically significant(both P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups[4.00%(2/50)vs 8.00%(4/50)](χ^(2)=0.177,P=0.673).Conclusion Ultrasound-guided PNB has a longer onset time of pain block,but it can more stably maintain the basic signs of elderly patients undergoing lower limb orthopedic surgery,accelerate the recovery of postoperative cognitive function,and ensure the safety of anesthe⁃sia.

关 键 词：下肢骨折 超声引导 外周神经阻滞 基础体征 认知功能 

分 类 号：R614[医药卫生—麻醉学]