超声引导下神经阻滞复合全身麻醉对下肢膝关节置换手术患者术后认知功能障碍发生率的影响

Effect of Nerve Block Combined with General Anesthesia Under Ultrasound Guidance on the Incidence of Postoperative Cognitive Dysfunction in Patients Undergoing Lower Limb Knee Arthroplasty

目的:探究超声引导下神经阻滞复合全身麻醉对下肢膝关节置换手术患者术后认知功能障碍发生率的影响。方法:对2019年8月~2020年8月在本院进行诊治的下肢关节置换术患者78例的临床资料进行分析,并根据患者术中采用不同麻醉方式进行分组,对照组39例患者采用单一的全麻方案,观察组39例患者则采用超声引导下神经阻滞复合全身麻醉方案,将两组患者麻醉以及术后情况进行对比分析,以评估其疗效。结果:观察组患者的麻醉药物用量、麻醉起效时间以及麻醉苏醒时间均较对照组的更短;且观察组患者术后24hVAS评分低于对照组,术后MMSE评分高于对照组,P<0.05;患者的术后认知功能障碍发生率为2.56%,低于对照组的7.69%,术后谵妄发生率为2.56%,低于对照组的10.27%,P>0.05。结论:对于下肢膝关节置换术患者,采用超声引导下神经阻滞复合全身麻醉的疗效显著,可明显改善患者的麻醉情况,同时对改善术后认知功能障碍以及缓解疼痛感均有较好的效果。

Objective:To investigate and analyze the effect of nerve block combined with General Anesthesia under ultrasound guidance on postoperative cognitive dysfunction in patients with lower limb knee arthroplasty.Methods:The clinical data of 78 patients who underwent lower limb joint replacement in our hospital from August 2019 to August 2020 were analyzed,39 patients in the control group were given single general anesthesia,39 patients in the observation group were given ultrasound-guided nerve block combined with general anesthesia.Results:The anesthetic dosage,onset time and recovery time of the observation group were shorter than those of the control group,and the 24hVAS score of the observation group was lower than that of the control group,the MMSE score was higher than that of the control group(P<0.05).The incidence of postoperative cognitive dysfunction was 2.56%,which was lower than that of the control group(7.69%).The incidence of postoperative delirium was 2.56%,which was lower than that of the control group(10.27%,P>0.05).Conclusion:The effect of nerve block combined with general anesthesia under the guidance of ultrasound is significant for the patients undergoing lower limb knee arthroplasty,and it can improve the anesthesia condition of the patients,at the same time,it has a good effect on improving postoperative cognitive dysfunction and relieving pain sensation.