布比卡因脂质体行PENG与LFCN联合阻滞对老年全髋关节置换术患者术后应激和认知功能的影响OA
Effects of PENG+LFCN block with bupivacaine liposome on stress and cognitive function in elderly patients after total hip arthroplasty
目的:探究布比卡因脂质体(LB)行髋关节囊周围神经(PENG)与股外侧皮神经(LFCN)联合阻滞,对老年全髋关节置换术患者术后应激和认知功能的影响.方法:将100例行全髋关节置换术的老年患者按照干预方式不同分为观察组(n=50,LB行PENG+LFCN阻滞)与对照组(n=50,罗哌卡因行PENG+LFCN阻滞).比较两组患者术后镇痛情况、应激反应、认知功能、恢复情况及不良反应发生情况.结果:术后12、24、48 h,观察组静息时视觉模拟评分(VAS)、活动时VAS评分、自控静脉镇痛泵(PCIA)的按压次数均低于对照组(P<0.05).术后1 d,观察组皮质醇(COR)、肾上腺素(N)和去甲肾上腺素(NE)水平均低于对照组(P<0.05).术后3、7 d,观察组简易智力状态检查表(MMSE)评分均高于对照组(P<0.05).观察组术后首次下床活动时间、术后住院时间均短于对照组(P<0.05).结论:LB行PENG与LFCN联合阻滞用于老年全髋关节置换术患者,术后镇痛效果优于罗哌卡因,可减轻术后应激反应,保护认知功能,促进恢复.
Objective:To explore the effects of pericapsular nerve group(PENG)and lateral femoral cutaneous nerve(LF-CN)block with bupivacaine liposome(LB)on stress and cognitive function in elderly patients after total hip arthroplasty.Methods:According to different intervention methods,100 elderly patients undergoing total hip arthroplasty were divided into observation group(n=50,PENG+LFCN block with LB)and control group(n=50,PENG+LFCN block with ropivacaine).The postoperative analgesia,stress response,cognitive function,recovery and adverse reactions were compared between the two groups.Results:At 12,24 and 48 h after surgery,VAS scores under rest and motion states,and compression frequency of patient controlled intravenous analgesia(PCIA)in observation group were lower than those in control group(P<0.05).At 1 d after surgery,levels of cortisol(COR),adrenaline(N)and norepinephrine(NE)in observation group were lower than those in control group(P<0.05).At 3 and 7 d after surgery,scores of mini-mental state examination(MMSE)in observation group were higher than those in control group(P<0.05).The first leaving bed time and length of hospital stay in observation group were shorter than those in control group(P<0.05).Conclusion:Compared with ropivacaine,PENG+LFCN block with LB has better analgesic effect in elderly patients after total hip arthroplasty,which can alleviate postoperative stress response,protect cognitive function and promote recovery.
谢玉海;张利亮;惠庭旗玉
青海红十字医院麻醉科,青海 西宁 810000青海红十字医院麻醉科,青海 西宁 810000青海红十字医院麻醉科,青海 西宁 810000
医药卫生
全髋关节置换术老年布比卡因脂质体髋关节囊周围神经阻滞股外侧皮神经阻滞应激反应认知功能
Total hip arthroplastyElderlyBupivacaine liposomePericapsular nerve groupLateral femoral cutaneous nerve blockStress responseCognitive function
《川北医学院学报》 2026 (8)
934-937,4
青海省卫生健康系统指导性计划项目(2022-wjzdx-83)
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