|
|
Effects of Lumbar Plexus Sciatic Nerve Block Combined with Low-dose Propofol Anesthesia on Hemodynamics, Postoperative Cognitive Function and Complications in Elderly Patients with Intertrochanteric Fracture |
GUO Ping, HE Lei |
Xi'an Gem Flower Changqing Hospital,Xi'an, Shaanxi, 710200 |
|
|
Abstract 【Objective】 To investigate the effect of lumbar plexus sciatic nerve block combined with low-dose propofol anesthesia on hemodynamics, postoperative cognitive function and complications in elderly patients with intertrochanteric fracture.【Methods】 Sixty patients with intertrochanteric fracture in our hospital from September 2017 to September 2019 were selected and randomly divided into observation group and control group (30 cases in each group). The control group was operated under general anesthesia, and the observation group was treated with lumbar plexus sciatic nerve block combined with low-dose propofol anesthesia. The hemodynamic indexes [heart rate (HR) and mean arterial pressure (MAP)], postoperative cognitive function [Montreal Cognitive Assessment Scale (MoCA), Mini Mental State Examination (MMSE) score], anesthetic effect and complications of the two groups were compared.【Results】 The MAP and HR index levels of the two groups at T1 were significantly lower than those at T0, but the map level of the control group at T1 was significantly lower than that of the observation group, and the difference was statistically significant (P>0.05); The excellent and good rate of anesthesia effect in the observation group was significantly higher than that in the control group (86.67% vs 60.00%), and the differences were statistically significant (P<0.05). The MoCA and MMSE scores of the two groups at 1 day and 3 days after operation were lower than those before operation, but the MoCA and MMSE scores of the observation group were significantly higher than those of the control group. The incidence of complications in the observation group was significantly lower than that in the control group (16.67% vs 40.33%), and the differences were statistically significant (P<0.05).【Conclusion】 Lumbar plexus sciatic nerve block combined with low-dose propofol anesthesia for elderly patients with intertrochanteric fracture has the advantages of stable hemodynamics and significant anesthetic effect, which can effectively reduce the occurrence of postoperative cognitive dysfunction and postoperative complications.
|
Received: 15 January 2021
|
|
|
|
|
[1] 桑本玲, 李家新. 腰丛联合坐骨神经阻滞复合小剂量丙泊酚麻醉在高龄患者股骨粗隆间骨折手术中的应用[J].中华神经医学杂志, 2016,15(9):945-950. [2] 朱小兵, 吴论, 彭学强. 超声引导腰骶丛阻滞联合鼻咽通气道用于合并肺部及腰椎疾病高龄患者髋关节置换术的可行性[J].中华麻醉学杂志, 2017,37(7):856-858. [3] 秦爱敏, 马春宇, 张增梅. 腰丛-坐骨神经阻滞对高龄全髋关节置换术术后转归的影响[J].中华实验外科杂志, 2019,36(1):157-159. [4] 张云慧. 超声引导神经阻滞复合全身麻醉在胫骨骨折手术中的应用[J].临床麻醉学杂志, 2015,31(3):228-230. [5] 刘湘钰, 黄穗葵, 邓瑞华. B超引导下腰丛复合坐骨神经阻滞麻醉对老年股骨粗隆间骨折患者麻醉效果与免疫功能的影响[J].中国医师杂志, 2018,20(11):1689-1692. [6] 郭延洪,阿良德,贾珍.腰丛-坐骨神经阻滞复合七氟烷对老年髋关节置换患者置换后 认知功能的影响:前瞻性、单中心、开放性、随机对照临床试验[J].中国组织工程研究, 2017,21(11):1675-1680. [7] 陶强. 椎管内麻醉和全身麻醉在高龄股骨粗隆间骨折患者手术中的应用价值探讨[J].深圳中西医结合杂志, 2015, 25(3):139-140. [8] 韩晓亮.丙泊酚对电离辐射引起小鼠造血系统损伤的防护作用[J].国际药学研究杂志, 2016,43(5):931-934. [9] 郑铭锋, 汪翼凡, 应小樟. 股骨粗隆间骨折老年患者实施中西医结合治疗对髋关节功能改善的影响[J].中华中医药学刊, 2018,37(7):331-334. [10] 崔雪娅,马桂丽,腰硬联合麻醉用于老年全髋关节置换术的效果及对患者血流动力学与认知功能的影响[J].临床医学, 2018,19(4):547-549. [11] 蔡立松, 王蕊, 郭平选. 三种不同麻醉方式对中老年患者术后发生认知功能障碍的对比[J].实用医学杂志, 2018,34(11):476-479. [12] 李红, 刘叶, 吴军娜. 不同镇静深度对轻度认知功能障碍老年患者术后认知功能的影响[J].中华麻醉学杂志, 2018,38(12):1437-1440. [13] 田庆显, 徐子彧, 杜心如,等. 75岁及以上骨质疏松性股骨粗隆间骨折患者手术方法的选择[J].中华老年医学杂志, 2016,35(2):123-127. [14] 魏滨.不同麻醉方法对髋部骨折老年患者术后转归的影响[J].北京大学学报(医学版), 2017,49(6):1008-1013. [15] 刘添银, 陈世彪, 候本超. 不同麻醉方式对股骨粗隆间骨折患者的影响[J].当代医学, 2016,25(17):43-44. [16] 胡淑娜.全身麻醉与椎管内麻醉对高龄股骨粗隆间骨折患者术后恢复效果的影响[J].中国社区医师, 2018,34(18):18-21. |
|
|
|