硬膜外麻醉对老年骨折手术患者认知损伤、睡眠质量的影响

Effects of Epidural Anesthesia on Cognitive Impairment and Sleep Quality in Elderly Patients Undergoing Fracture Surgery

目的:探讨硬膜外麻醉对老年骨折手术患者认知损伤、睡眠质量的影响。方法:选取2022年6月至2023年6月福建省泉州市中医院麻醉科收治的老年骨折手术患者52例作为研究对象,按照双盲法分为对照组和观察组,每组26例。分别实施全身麻醉和硬膜外麻醉,比较2组麻醉效果。结果:麻醉后T_(1)、T_(2)时,2组HR加快,MAP降低,观察组HR较对照组低,MAP较对照组高(均P<0.05)。术后6 h,2组MMSE评分下降,观察组高于对照组;术后12 h,2组MMSE评分升高,观察组高于对照组(均P<0.05)。麻醉后,2组PSQI评分下降,观察组低于对照组,且组不良反应较对照组低(均P<0.05)。结论:对老年骨折手术患者实施硬膜外麻醉,有助于维持血流动力学稳定,减轻认知损伤,减少对睡眠质量的影响,安全性更高。

Objective:To investigate the effects of epidural anesthesia on cognitive impairment and sleep quality in elderly patients undergoing fracture surgery.Methods:Fifty-two elderly patients with fracture surgery admitted to our hospital from June 2022 to June 2023 were selected as the study objects,and were divided into control group(n=26)and observation group(n=26)by double-blind method.General anesthesia and epidural anesthesia were administered respectively,and the anesthetic effects of the two groups were compared.Results:At T_(1)and T_(2)after anesthesia,HR was accelerated,MAP was decreased,HR in observation group was lower than control group,MAP was higher than control group(P<0.05).At 6 h after operation,MMSE score decreased in both groups,and the observation group was higher than the control group.At 12 h after operation,MMSE scores of both groups were increased,and the observation group was higher than the control group(P s<0.05).After anesthesia,PSQI score decreased in both groups,and the observation group was lower than the control group,and the adverse reactions were lower in the group than the control group(P s<0.05).Conclusion:Epidural anesthesia in elderly patients undergoing fracture surgery is helpful to maintain hemodynamic stability,reduce cognitive impairment,reduce the impact on sleep quality,and has higher safety.