腰硬联合麻醉与全身麻醉应用于髋关节骨折手术患者的效果及改善睡眠质量的观察

Effect of Combined Spinal Epidural Anesthesia and General Anesthesia on Patients Undergoing Hip Fracture Surgery and Improvement of Sleep Quality

目的:探究髋关节骨折手术行腰硬联合麻醉与全身麻醉的效果及对睡眠质量的影响。方法:选取2021年10月至2022年10月福建省南安市医院麻醉科行手术治疗的髋关节骨折患者180例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组90例。对照组采取全身麻醉,观察组采取腰硬联合麻醉。比较2组各时段疼痛程度、应激反应、睡眠质量以及认知功能。结果:术后6 h、12 h、24 h,观察组视觉模拟评分(VAS)、血浆肾上腺素(E)、去甲肾上腺素(NE)和PSQI各维度得分均低于对照组,且观察组血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)均高于对照组,差异有统计学意义(P<0.05)。结论:髋关节骨折手术行腰硬联合麻醉,相比全身麻醉有更好镇痛作用,减轻患者手术应激反应和对认知功能的影响,有助于改善术后睡眠质量。

Objective:To explore the effects of combined spinal and epidural anesthesia and general anesthesia on the quality of sleep in hip fracture surgery.Methods:A total of 180 patients with hip fracture who underwent surgical treatment in the Department of Anesthesiology of Nan′an Hospital,Fujian Province from October 2021 to October 2022 were selected as the study objects.The random number table method is divided into two groups with 90 cases each.The control group received general anesthesia,while the observation group received combined spinal epidural anesthesia.Compare the pain level,stress response,sleep quality,and cognitive function between the two groups at different time periods.Results:Visual analogue score(VAS),plasma epinephrine(E),norepinephrine(NE) and PSQI scores in the observation group were lower than those in the control group at 6 h,12 h and 24 h after surgery,and serum nerve growth factor(NGF) and brain-derived neurotrophic factor(BDNF) in the observation group were higher than those in the control group.The difference was statistically significant(P<0.05).Conclusion:Combined spinal and epidural anesthesia for hip fracture surgery has better analgesic effect than general anesthesia,reduces the stress reaction of surgery and the impact on cognitive function,and helps to improve the quality of sleep after surgery.