Effects of dexmedetomidine-assisted lumbar plexus-sciatic nerve block anesthesia on stress response and cognitive function in patients undergoing knee arthroplasty
Objective To investigate the effects of dexmedetomidine-assisted lumbar plexus-sciatic nerve block anesthesia on stress response and cognitive function in patients undergoing knee arthroplasty.Methods A total of 100 patients undergoing knee arthroplasty admitted in our hospital from March 2020 to March 2022 were selected and divided into observation group(n=50)and control group(n=50)by random number table method.Both groups underwent lumbar plexus-sciatic nerve block anesthesia.The control group was anesthetized with midazolam,and the observation group was anesthetized with dexmedetomidine.The heart rate(HR),mean arterial pressure(MAP)and visual analogue scale(VAS)score were compared between the two groups before entering the operating room(T0),immediately after the completion of nerve block(T1),15 min after the start of surgery(T2),immediately after surgery(T3);the levels of adrenocorticotrophic hormone(ACTH),nitric oxide(NO),norepinephrine(NE)and Mini-Mental State Examination(MMSE)score were compared between the two groups before and 4 h after operation.Results At T0,there were no significant differences in HR and MAP between the two groups(P>0.05);at T1,T2 and T3,the HR and MAP of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).At T1,T2 and T3,the VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Before operation,there were no significant differences in ACTH,NO and NE levels between the two groups(P>0.05);at 4 h after operation,the levels of ACTH,NO and NE in the two groups increased significantly,but those in the observation group were lower than the control group(P<0.05).At 4 h after operation,the MMSE score of the two groups decreased significantly,but that in the observation group was higher than the control group(P<0.05).Conclusion Dexmedetomidine-assisted lumbar plexus-sciatic nerve block anesthesia can reduce the stress response and decrease the occurrence of cognitive dysfunction in patients undergoing knee arthroplasty,which is worthy of promotion.
dexmedetomidinelumbar plexus-sciatic nerve block anesthesiaknee arthroplastystress responsecognitive function