Effect of Low-dose Bupivacaine Anesthesia on Cognitive Function and Hemodynamics in Elderly Patients with Lower Extremity Fractures Treated with Intramedullary Nailing
Objective:To analyze the effect of low-dose bupivacaine subarachnoid anesthesia on cognitive function and hemodynamics in elderly patients with lower limb fractures.Methods:A total of 60 elderly patients with lower limb fractures in our hospital from January 2020 to January 2023 were selected,and were randomly divided into the control group and the study group,with 30 cases in each group.The control group was injected with 2 mL 0.50%bupivacaine+1 mL of glucose solution for subarachnoid anesthesia,and the study group was injected with 1 mL of 0.50%bupivacaine+1 mL of 10%glucose solution for subarachnoid anesthesia.The cognitive kinetic energy(MMSE score),hemodynamics and the incidence of postoperative delirium were compared between the two groups.Results:At 1 h after operation,MMSE scores of the two groups decreased,and returned to the normal level at 24 h after operation.The range of decline of the study group was lower than that of the control group,and the level of recovery was faster than that of the control group(P<0.05);The levels of DBP,SBP,map and HR increased at T2 and T3,and fell back to the level close to to at T4,but the rising and floating trend of the study group was smaller,and the recovery was faster(P<0.05);There was no significant difference in the incidence of postoperative delirium between the two groups(P>0.05).Conclusion:Low-dose bupivacaine subarachnoid anesthesia is conducive to stabilizing hemodynamics in elderly patients undergoing lower limb fracture surgery,promoting the recovery of postoperative cognitive function,and the incidence of postoperative delirium is low.
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