The Anesthetic Effects of CSEA and LPSB in Elderly Patients Undergoing Hip Fracture Surgery and their Impact on Cognitive Function
[Objective]To observe the anesthetic effects of combined spinal-epidural anesthesia(CSEA)and lumbar plexus-sciatic nerve block(LPSB)in elderly patients undergoing hip fracture surgery and their im-pact on cognitive function.[Methods]Eighty elderly patients undergoing internal fixation surgery for hip frac-tures were randomly divided into an observation group and a control group,with 40 patients in each group.The control group received CSEA anesthesia,while the observation group received LPSB anesthesia.The sur-gical conditions,hemodynamic parameters at various time points[heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO2)],stress response indicators[glucose(GLU),interleukin-6(IL-6),corti-sol(COR)],pain levels before and after surgery,cognitive function changes,and adverse events were com-pared between the two groups.[Results]There were no statistically significant differences in surgery time and blood loss between the two groups(P＞0.05).However,the observation group had lower infusion volumes,longer anesthesia onset times,and longer block duration compared to the control group(P＜0.05).At 30 mi-nutes intraoperatively,both groups showed lower HR and MAP than preoperatively and at 1 hour postopera-tively(P＜0.05),with the observation group having higher HR and MAP than the control group(P＜0.05).The GLU,IL-6,and COR levels at 30 min intraoperatively and 1 hour postoperatively were higher than those before operation in both groups,which showed a continuous increase(P＜0.05).However,the obser-vation group had lower GLU,IL-6,and COR levels than the control group at these time points(P＜0.05).Postoperatively,both groups had lower visual analog scale(VAS)pain scores and higher Montreal Cognitive Assessment(MoCA)scores than preoperatively(P＜0.05),with the observation group showing lower VAS and higher MoCA scores than the control group(P＜0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(P＞0.05).[Conclusion]LPSB offers better anesthetic effects than CSEA for elderly patients undergoing hip fracture surgery.It helps stabilize blood circu-lation,reduces stress responses,has a smaller impact on cognitive function,and does not result in significant adverse events,which makes it suitable for clinical use.
Hip Fractures/SUAnesthesia,SpinalAnesthesia,EpiduralCognitionAged
万方数据
维普
