Effects of serratus anterior muscle plane block combined with general anesthesia on cognitive function in elderly patients after thoracoscopic radical resection of lung adenocarcinoma
Effects of serratus anterior muscle plane block combined with general anesthesia on cognitive function in elderly patients after thoracoscopic radical resection of lung adenocarcinoma
Objective To investigate the effects of ultrasound-guided serratus anterior muscle plane block(SAPB)combined with general anesthesia on early cognitive function and complications in elderly patients after thoracoscopic radical re-section of lung adenocarcinoma.Methods 60 elderly patients undergoing elective thoracoscopic radical surgery for lung ade-nocarcinoma in Cancer Hospital of Nantong City from January 2023 to December 2023 were selected and divided into two groups by random number table method:combined group(n=30,SAPB combined with general anesthesia under ultrasound guidance)and general anesthesia group(n=30,tracheal intubation general anesthesia).In the combined group,SAPB was guided under ultrasound before anesthesia induction and blocked for 20 min.After the successful block was judged by acupunc-ture,general anesthesia with tracheal intubation was performed.The venous blood samples were collected on day 1 before sur-gery and on days 1,3,and 7 after surgery to measure the concentrations of serum S100β protein and neurospecific enolase(NSE).The pain scores of both groups at 6,12,24,and 48 h after surgery were recorded.The intraoperative and postopera-tive opioid analgesic drug dosage and remedial analgesia in both groups were recorded.Patients'cognitive function was assessed with the Mini-Mental State Scale(MMSE)on 1 day before surgery and 1,3,and 7 days after surgery.The incidence of post-operative cognitive dysfunction and other complications were recorded and compared between the two groups.Results Com-pared with the general anesthesia group,the VAS score of the combined group was lower,the dosage of remifentanil during op-eration and sufentanil after operation was less,and the rate of remedial analgesia was lower;the MMSE scores on postoperative days 1,3,and 7 were higher,and the incidence of cognitive dysfunction within 7 days was lower;the concentrations of serum S100 β protein and NSE were lower after surgery;the incidence of nausea and vomiting was lower.The above differences be-tween the two groups were statistically significant(P＜0.05).Conclusion Ultrasound-guided SAPB combined with general anesthesia may have little effect on cognitive function in elderly patients after thoracoscopic radical resection of lung adenocarci-noma.It has good analgesic effect,can reduce incidence of complications,and is helpful to improve the prognosis of patients.
关键词
老年/肺腺癌/肺腺癌根治术/前锯肌/全身麻醉/神经阻滞/认知障碍
Key words
elderly/lung adenocarcinoma/radical resection of lung adenocarcinoma/serratus anterior/general anesthe-sia/nerve block/cognitive dysfunction
维普
万方数据