Effectiveness of Nerve Block Combined with General Anesthesia and Laryngeal Mask General Anesthesia on Inter-trochanteric Fracture of the Femur in the Elderly and the Effect on MMSE
Objective:To observe the effect of applying different nerve blocks when applying laryngeal mask general anesthe-sia during intertrochanteric fracture of the femur in the elderly,and to analyze the effect on patients'postoperative cognition.Methods:A total of 137 elderly patients with intertrochanteric fracture of the femur admitted to the hospital from September 2020 to March 2022 were selected as the study subjects,and were divided into Group A(n=45,laryngeal mask general anesthesia alone),and the rest of the patients were divided into Group B(n=46,lumbar plexus-sciatic nerve block compounded with general anesthesia by laryngeal mask)and Group C(n=46,L1-L2 paravertebral nerve block compounded with general anesthesia by laryn-geal mask)according to the different modes of nerve block.The anesthetic results,surgical outcomes and prognosis of patients in the three groups were compared.Results:Postoperatively,SPO2 and PaO2 of patients in group B were higher than those in groups A and C,and MAP and PaCO2 were lower than those in groups A and C.The difference was statistically significant(F=27.36,195.84,34.27,11.77,P＜0.05).The Harris and MMSE scores of patients in Group B were slightly higher than those of group A and C.The difference was statistically significant(F=51.80,94.63,P＜0.05).Superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px)were higher and malondialdehyde(MDA)was lower than that of group A and C in patients of group B,and the difference was statistically significant(F=33.93,201.68,85.16,4.60,P＜0.05).The difference in the occurrence of adverse re-actions among the three groups was not statistically significant(χ2=1.099,P＞0.05).Conclusion:Intraoperative laryngeal mask general anesthesia is combined with lumbar plexus-sciatic nerve block in elderly patients with intertrochanteric fracture of the fe-mur is more advantageous to improve the patient's vital signs,reduce the stress response,and avoid cognitive impairment.
Femoral intertrochanteric fracture in the elderlyLumbar plexus sciatic nerve blockParavertebral nerve blockLa-ryngeal mask general anesthesiaCognitive function
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