Effect of nerve stimulator-guided sciatic nerve-femoral nerve block on cognitive impairment inelderly patients after total hip arthroplasty(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2018年第9期
- Page:
- 1094-1098
- Research Field:
- 医学生物物理
- Publishing date:
Info
- Title:
- Effect of nerve stimulator-guided sciatic nerve-femoral nerve block on cognitive impairment inelderly patients after total hip arthroplasty
- Author(s):
- XIAO Shuiliang; ZHOU Hongshe
- Department of Anesthesiology, Xi’an Gaoxin Hospital, Xi’an 710075, China
- Keywords:
- Keywords: elderly patient; total hip arthroplasty; nerve stimulator; sciatic nerve-femoral nerve block; cognitive impairment
- PACS:
- R614
- DOI:
- 10.3969/j.issn.1005-202X.2018.09.018
- Abstract:
- Abstract: Objective To investigate the effects of nerve stimulator- guided sciatic nerve- femoral nerve block on cognitiveimpairment and hemodynamics in elderly patients after total hip arthroplasty for providing some references for the developmentof a reasonable anesthesia regimen for elderly patients receiving total hip arthroplasty. Methods A total of 86 elderly patientsundergoing total hip arthroplasty in Xi’an Gaoxin Hospital from January 2015 to January 2017 were selected as the subjects.According to different anesthesia regimens, the patients were divided into control group (given epidural anesthesia, n=45) andobservation group (given nerve stimulator-guided sciatic nerve-femoral nerve block anesthesia, n=41). The changes ofhemodynamic indexes, including mean arterial pressure (MAP) and heart rate, in the two groups at different time points［enteringthe operating room (T0), the beginning of operation (T1), 30 minutes after the beginning of operation (T2), the end of operation(T3)］were analyzed. The anesthetic effects (duration of analgesia, time to the highest block level), cognitive impairment［minimentalstate examination (MMSE)］and adverse reactions were compared between two groups. Results No significant differenceswere found in MAP, heart rate and preoperative MMSE score between two groups at T0 (P>0.05). The MAP of both two groupswas significantly decreased at T1, T2 and T3 as compared with T0. At T1 and T2, only the heart rate of control group wasdecreased significantly (P<0.05). The changes of MAP and heart rate in control group at different time points were significantlygreater than those in observation group (P<0.05). The duration of analgesia was significantly longer and the time to the highestblock level was shorter in observation group as compared with control group (P<0.05). The MMSE scores in observation groupat 1 day and 7 days after finishing operation were significantly higher than those in control group (P<0.05). The total incidenceof adverse reactions in observation group was 21.95%, significantly lower than 44.44% in control group (P<0.05). Conclusion Nerve stimulator- guided sciatic nerve- femoral nerve block not only has remarkable anesthetic effects for elderly patientsundergoing total hip arthroplasty, but also effectively reduces postoperative cognitive impairment, with high safety and little effectson hemodynamics.
Last Update: 2018-09-28