Effect of Nerve Block Combined with General Anesthesia on Postoperative Analgesia and Cognitive Function in Elderly Patients undergoing Artificial Femoral Head Replacement
Objective:To investigate the effects of fascia iliaca compartment block(FICB)combined with general anesthesia on perioperative analgesia and postoperative cognitive function in elderly patients undergoing artificial femoral head replacement(FHR).Methods:104 elderly patients undergoing FHR were selected and were randomly divided into control group and experimental group,each group has 52 cases.The two groups was treated with simple general anesthesia,FICB combined with general anesthesia respectively.Visual analogue scale(VAS)scores were recorded at 4 h,12 h,24 h and 48 h after operation.Record the analgesia of the two groups;before operation and 1 d,3 d and 7 d after operation,the mini-mental state examination(MMSE)was used to evaluate the patients's cog-nitive function.The analgesic adverse reactions and hospitalization time of the two groups were recorded.The serum levels of inter-leukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected 1 day before operation and 1 day after operation.Results:At 4 h～24 h after surgery,the experimental group had a lower VAS score than the control group(P＜0.05).The dosage of remifentanil in the experi-mental group decreased comparing with the control group(P＜0.05),and the dosage of sufentanil decreased within 48 hours after operation(P＜0.05).Compared with the control group at 1 day after operation and 3 days after operation,the MMSE score of the experimental group was higher(P＜0.05).Within 7 days after operation,compared with the control group,the incidence of POCD in the experimental group was lower(9.62％ vs 25.00％,P＜0.05).Compared with the control group,the incidence of postoperative nausea and vomiting in the experimental group decreased significantly(P＜0.05),and the postoperative hospital stay was shortened(P＜0.05).At 1 day after oper-ation,compared with the control group,the experimental group had lower levels of IL-6 and TNF-α(P＜0.05).Conclusion:FICB com-bined with general anesthesia can provide better analgesic effect for elderly patients with FHR,reduce opioid consumption,reduce in-flammatory levels,and improve postoperative cognitive function.
Artificial femoral head replacementOld ageNerve blockFascia iliaca compartment blockAnalgesiaCognitive func-tion
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