区域阻滞麻醉与老年患者术后神经系统功能、病死率关系的研究进展

Research progress of the relationship between regional anesthesia and postoperative neurological function and mortality in elderly surgical patients

背景区域阻滞麻醉应用于老年患者手术日益增多，其对老年患者术后神经系统功能、病死率的影响有待总结。目的通过文献综述，分析区域阻滞麻醉对老年患者术后神经系统、病死率的影响。内容讨论区域阻滞麻醉与老年患者术后神经系统功能，包括术后谵妄、认知功能障碍、脑卒中以及与病死率之间的关系。趋向区域阻滞麻醉可以减少老年患者术后肺部并发症，减少术后早期认知功能障碍，与全身麻醉相比，具有一定优势。区域阻滞麻醉是否能降低老年患者术后病死率、心血管并发症发生率、谵妄发生率、围手术期脑卒中发生率尚有待于进一步研究。

Background The use of regional anesthesia for elderly surgical patients has recently become increasingly popular.However, the benefits of regional anesthesia on postoperative neurological function and mortality of elderly patients is still in controversy. Objective Review the clinical evidences of regional anesthesia and general anesthesia on postoperative neurological function and mortality in elderly surgical patients. Content This review summarizes the impact of regional anesthesia and general anesthesia on postoperative mortality, incidence of cognitive dysfunction, delirium, perioperative stroke, pulmonary and cardiovascular complications in elderly surgical patients. Trend Regional nerve block may reduce the incidence of postoperative pulmonary complications, early postoperative cognitive dysfunction in elderly surgical patients, it is not certain whether regional nerve block can reduce the incidence of postoperative mortality, cardiovascular complications and perioperative stroke. The relationship between nerve block and the postoperative outcomes of elderly patients remains to be further studied.