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- Title
超声引导下髂筋膜神经阻滞联合全麻对老年股骨近端骨折患者术后血清 疼痛介质PGE2、SP 和认知功能及睡眠质量的影响.
- Authors
宋洁; 胡宪文; 陈齐; 王家友; 刘晓芬; 盛奎; 张杨; 吴路楠
- Abstract
To observe the effects of ultrasound-guided iliac fascia nerve block combined with general anesthesia on serum pain mediators prostaglandin E2 (PGE2) and substance P (SP), cognitive function and sleep quality in elderly patients with proximal femoral fracture. 80 elderly patients with proximal femoral fractures who were treated by elective surgery in our hospital from August 2018 to September 2021 were selected, and they were divided into and control group (40 cases, conventional general anesthesia) and observation group (40 cases, ultrasound-guided iliac fascia nerve blocke combined with general anesthesia) according to the random number table method. The anesthetic effect, hemodynamics, pain condition, cognitive function and sleep quality of the two groups were compared, the safety of different modes of anesthesia were observed. The wake-up time and extubation time of the observation group were shorter than those of the control group, and the dosage of propofol was less than that of the control group (P<0.05). The heart rate (HR) first increased and then decreased from the time of laryngeal mask implantation (T1) to the time of postoperative (T3) in two groups, and the mean arterial pressure (MAP) first decreased and then increased (P<0.05). HR of the observation group at T1 ~ T3 time point was lower than that of the control group, and MAP was higher than that in the control group (P<0.05). The levels of serum PGE2 and SP and the visual pain scale (VAS) score in the two groups at 24 h after operation increased, and the observation group was lower than the control group (P<0.05). The Montreal Cognitive Assessment Scale (MoCA) score in the two groups at 1 d, 2 d and 3 d after operation decreased first and then increased compared with those before operation (P<0.05). The MOCA scores of the observation group at 2 d and 3 d after operation were higher than those of the control group (P<0.05). The Pittsburgh Sleep Quality Assessment Scale (PSQI) scores in the two groups at 1 d, 2 d and 3 d after operation increased at first and then decreased compared with those before operation (P<0.05). The PSQI scores of the observation group at 1 d, 2 d and 3 d after operation were lower than those of the control group (P<0. 05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). In elderly patients with proximal femoral fracture, ultrasound-guided iliac fascia nerve block combined with general anesthesia has a significant analgesic effect, which can stabilize the body's hemodynamics, and reduce the impact on cognitive function and sleep quality, with good safety.
- Subjects
PROXIMAL femoral fractures; HIP fractures; SLEEP quality; MONTREAL Cognitive Assessment; NERVE block; SUBSTANCE P; GENERAL anesthesia
- Publication
Progress in Modern Biomedicine, 2022, Vol 22, Issue 23, p4536
- ISSN
1673-6273
- Publication type
Article
- DOI
10.13241/j.cnki.pmb.2022.23.027