连续腰丛神经阻滞对膝关节置换手术后患者认知功能的影响

Effect of Continuous Lumbar Plexus Block on Cognitive Function in Patients after Knee Joint Replacement

【目的】探讨连续腰丛神经阻滞对膝关节置换手术后患者认知功能的影响。【方法】在本院接受治疗的82例膝关节置换手术患者,随机分为两组,每组41例。对照组接受静脉自控镇痛,观察组接受连续腰丛神经阻滞镇痛,比较两组患者苏醒时间以及术后视觉模拟(VAS)评分、不良反应的发生率以及简易精神状态量表(MMSE)评分变化和认知功能障碍的发生率。【结果】观察组患者的术后苏醒时间和术后12h、24h的VAS评分均低于对照组,且两组相比较差异均有显著性(P<0.05);观察组患者恶心呕吐、头晕、尿潴留以及皮肤瘙痒等不良反应的总发生率低于对照组,且差异有显著性(P<5);观察组患者的术后MMSE评分高于,认知功能障碍发生率低于对照组,且两组比较差异有显著性(P<0.05)。【结论】连续腰丛神经阻滞应用于膝关节置换手术患者效果显著,能够加快患者的术后苏醒时间,对于减少患者的疼痛、术后并发症以及认知功能障碍的发生具有积极作用,值得临床推广。

[Objective]To explore the effect of continuous lumbar plexus block on cognitive function in patients after knee replacement surgery.【Methods】We selected 82 patients with knee replacement surgery who were treated in our hospital were as subjects.All patients were randomly divided into two groups,with 41 cases in each group.Patients in the control group received intravenous analgesia»while patients in the observation group received continuous lumbar plexus block for the surgery.The postoperative recovery time»the VAS score,the incidence of adverse reactions,the changes of the simple mental state scale and cognitive dysfunction were compared between the two groups.【Results】The recovery time of the observation group,the VAS score at 12h and 24h after operation in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions such as nausea and vomiting,dizziness,urinary retention in the observation group was 12.20%,which was lower than 31.71%in the control group(P<0.05).The MMSE score of the observation group was 24.73zh3.16,and only I case(2.44%)of cognitive dysfunction occurred.However,the MMSE score of the control group was 20.38±2.91,and the cognitive dysfunction occurred in 5 cases(12.20%).The differences between the two groups were statistically significant.(P<0.05).【Conclusion】Continuous lumbar plexus block is more effective in patients undergoing knee replacement surgery,which can accelerate the postoperative recovery time of patients and has a positive effect on reducing pain,postoperative complications and cognitive dysfunction.It is worth promoting clinically.