Effect of Combined Spinal-epidural Anesthesia on the Incidence of Postoperative Delirium in Patients with Artificial Femoral Head Replacement
Objective:To study the effect of combined spinal-epidural anesthesia on the incidence of postop-erative delirium in patients with artificial femoral head replacement.Methods:A total of 68 patients who received arti-ficial femoral head replacement in our hospital from January 2019 to December 2022 were selected,and were divided into general anesthesia group and combined spinal-epidural anesthesia group according to different anesthesia methods,with 34 cases in each group.The levels of pro-inflammatory factors such as interleukin-1β,tumor necrosis factor-α(IL-1β,TNF-α),anti-inflammatory factor heme oxygenase-1(HO-1),nerve injury-related protein neurofilament light chain(NfL),blood borne neurotrophic factor(BDNF)and nerve growth factor(NGF)were observed at half an hour before anesthesia,1 h and 2 d after operation,as well as the incidence rate of postoperative delirium.Results:There was no significant difference in the levels of IL-1β and TNF-α in the two groups at half an hour before anesthesia(P>0.05),while those in the study group were lower than those in the control group(P<0.05)at 1 h and 2 d after operation;There was no significant difference in HO-1 level at half an hour before anesthesia(P>0.05).The levels of HO-1 in the study group were higher than those in the control group at 1 h and 2 d after operation(P<0.05).There was no significant dif-ference in NfL level between the two groups at half an hour before anesthesia(P>0.05).The levels of NfL in the study group were lower than those in the control group at 1 h and 1 d after operation(P<0.05);The levels of BDNF and NGF in the study group were higher than those in the control group(P<0.05).The incidence of postoperative delirium in the study group was lower than that in the control group(P<0.05).Conclusion:Combined spinal-epidural anesthesia can effectively reduce the risk of postoperative delirium in patients with artificial femoral head replacement,improve the lev-el of inflammatory markers and neurological factors such as NfL and BDNF.
combined spinal-epidural anesthesiaartificial femoral head replacementpostoperative delirium
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