Application of periarticular infiltration analgesia combined with deopioid general anesthesia in total hip arthroplasty
Objective To investigate the effect of periarticular infiltration analgesia combined with deopioid anesthesia in total hip arthroplasty.Methods A total of 98 patients who underwent total hip arthroplasty(THA)in the hospital from August 2021 to August 2023 were selected and divided into an observation group and a control group using a random number table method,with 49 patients in each group.The con-trol group received conventional anesthesia,and the observation group received periarticular infiltration an-algesia combined with deopioid anesthesia.The perioperative hemodynamic indexes and inflammatory stress indexes were compared between the 2 groups of the patients.Numerical rating scale(NRS)was used to evaluate the pain degree at 2,6,12 and 24 h after the surgery.The first time of getting out of bed,the first walking distance,the length of hospital stay,adverse reactions,cognitive dysfunction and delirium were analyzed.Hip function was assessed by Harris score at discharge.Results The heart rate(HR)and mean arterial pressure(MAP)of the patients in the observation group were higher than those of the control group 10 minutes into the surgery,and the HR and MAP of the patients in the observation group were lower than those of the control group during and after the surgery(P＜0.05).There was no significant difference in resting and exercise NRS scores between the 2 groups at 2,6,12 and 24 h after the surgery(P＞0.05).The levels of interleukin-6,IL-1β,C-reactive protein(CRP)and heme oxygenase-1(HO-1)of the patients in the observation group were lower than those in the control group at 24 and 72 h after the surgery(P＜0.05).The first time of getting out of bed and staying in hospital of the patients in the observation group were shorter than those in the control group,and the first walking distance was lon-ger than that in the control group(P＜0.05).There was no significant difference in Harris score between the 2 groups at discharge(P＞0.05).The incidence of nausea,vomiting,dizziness and quadriceps muscle weakness of the patients in the observation group was lower than that in the control group(P＜0.05).The score of simple mental state scale(MMSE)of the patients in the observation group was higher than that in control group at 24 and 72 h after operation(P＜0.05).The incidence of cognitive dysfunction and delirium of the patients in the observation group was lower than that in the control group(P＜0.05).Conclusion Periarticular infiltration analgesia combined with deopioid anesthesia has good analgesic effect in total hip arthroplasty,which is conducive to maintaining hemodynamic stability,alleviating inflammato-ry stress,promoting postoperative recovery,and reducing the incidence of adverse reactions,cognitive dysfunction and delirium.
periarticular infiltration analgesiadeopioid general anesthesiatotal hip replacementstress re-actioncognitive functiondelirium
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