Application of ultrasound-guided femoral nerve block combined with general anesthesia in elderly patients undergoing knee ar-throplasty
Objective To explore the application effects of ultrasound-guided femoral nerve block combined with gener-al anesthesia in elderly patients undergoing knee arthroplasty,observe its effect on preventing postoperative delirium,and pro-vide reference for optimizing clinical analgesia plan.Methods 102 elderly patients undergoing knee arthroplasty in Hospital of 73rd Army Group of Chinese People's Liberation Army from February 2023 to February 2024 were selected and randomly divid-ed into study group and control group,with 51 cases in each group.The study group received ultrasound-guided femoral nerve block combined with general anesthesia,while the control group adopted general anesthesia.Both groups received intravenous patient-controlled analgesia after surgery for48 h.The postoperative pain level,analgesic remedy,movement block,analgesia-related adverse reactions,cognitive function and the incidence of postoperative delirium were compared between the two groups.Results The VAS scores of the study group at 6,12,24,and 48 h after surgery[(2.91±0.65),(2.95±1.04),(2.86±1.21),(3.12±0.87)]were lower than those of the control group[(3.03±0.84),(3.25±1.13),(3.20±1.19),(3.47±1.35)],and the differences were statistically significant(P＜0.05).The dosage of tramadol in the study group was lower than that in the control group[(53.79±10.28)mg vs(68.14±12.29)mg,P＜0.05];the rate of analge-sic remedy was lower than that in the control group(13.73％vs 31.37％,P＜0.05).The scores of modified Bromage in the study group at 6,12,24,and 48 h after surgery(0.55±0.24,1.25±0.33,3.20±0.77,4.74±0.51)were lower than those in the control group(0.63±0.28,1.39±0.40,3.46±0.61,4.81±0.37),and the differences were statistically sig-nificant(P＜0.05).There was no significant difference in the total incidence of analgesia-related adverse reactions between both groups(13.73％vs 17.65％,P＞0.05).The score of Mini-Mental State Examination(MMSE)at 72 h after surgery in the study group was higher than that in the control group[(28.53±0.21)vs(28.22±0.33),P＜0.05].There was no obvi-ous difference in the incidence of delirium within 72 h after surgery between both groups(1.96％vs 7.84％,P＞0.05).Conclusion The combination of ultrasound-guided femoral nerve block and general anesthesia in elderly patients undergoing knee arthroplasty can ensure the analgesic effect and reduce the amount of postoperative analgesic drugs.It does not aggravate the degree of lower extremity movement block,has fewer analgesia-related adverse reactions,and has less negative effect on postoperative cognitive function.This combined anesthesia plan has good analgesic effect and safety,can benefit patients,and has certain clinical application value.
万方数据
维普
