髂筋膜阻滞对老年髋关节置换术后认知功能的影响

Effect of fascia iliaca compartment block on cognitive functionin elderly patients after hip replacement

目的探索FICB对老年髋关节置换术后认知功能的影响。方法收集2022年1月-2022年10月在本院全麻下行髋关节置换术患者80例,随机分为观察组和对照组,每组各40例。比较2组不同时刻的MAP、HR、VAS评分,MMSE评分及术中麻醉镇痛药物用量。结果在观察组中,不同时刻HR、MAP、VAS评分均低于对照组,且差异具有统计学意义(P<0.05);MMSE评分在术后1d时高于对照组,差异具有统计学意义(P<0.05);术中舒芬太尼及瑞芬太尼的使用剂量明显减少,且差异具有统计学意义(P<0.05)。结论FICB能减少术中麻醉药物的使用剂量,维持术中血流动力学相对平稳,减少术后不良反应,能降低老年髋关节置换术术后早期POCD的发生率,对于老年患者术后认知功能障碍的康复较为有利。

Objective To explore the influence of FICB on cognitive function in the elderly after hip replacement.Methods A total of 80 patients underwent hip replacement under general anesthesia in our hospital from January to October 2022 were collected,they were randomly divided into observation group and control group,with 40 patients in each group.MAP,HR,VAS scores,MMSE scores and intraoperative anesthetic and analgesic medication usage between the two groups at different times were compared.Results In the observation group,the scores of HR,MAP and VAS at different times were lower than those of the control group,and the differences were statistically significant(P<0.05).The MMSE score was higher than that of the control group one day after operation,and the differences were statistically significant(P<0.05).Intraoperative doses of sufentanil and remifentanil were significantly reduced,the difference was statistically significant(P<0.05).Conclusions FICB can reduce the dose of intraoperative anesthetic drugs,maintain a relatively stable intraoperative hemodynamics,reduce postoperative adverse reactions,reduce the incidence of early POCD after hip replacement in elderly patients,and is beneficial to the rehabilitation of postoperative cognitive dysfunction in elderly patients.