喉罩浅全麻联合臂丛神经阻滞对老年上肢骨折手术患者术后疼痛、睡眠及认知功能的影响OA
The Influence of Laryngeal Mask Shallow General Anesthesia Combined with Brachial Plexus Nerve Block on Postoperative Pain,Sleep and Cognitive Function in Elderly Patients Undergoing Upper Fracture Limb Surgery
目的:探讨喉罩浅全麻联合臂丛神经阻滞对老年上肢骨折手术患者术后疼痛、睡眠及认知功能的影响,为老年上肢骨折手术患者的麻醉选择提供临床参考.方法:选取2023年4月—2025年12月于连州市人民医院行上肢骨折手术的 120 例老年患者,采用随机数字表法随机分为对照组(n=60)和观察组(n=60).对照组采用单纯臂丛神经阻滞,观察组采用喉罩浅全麻联合臂丛神经阻滞.比较两组术后疼痛指标、睡眠质量[理查兹-坎贝尔睡眠量表(Richards-Campbell sleep questionnaire,RCSQ)评分]、认知功能[简易精神状态检查表(MMSE)评分]、血清炎症因子(IL-6、TNF-α、CRP)水平及围手术期不良反应发生率.结果:本研究中对照组有 2 例因更改麻醉方式剔除,最终对照组 58 例、观察组 60 例.术后 6、12、24、48 h,观察组VAS评分均显著低于对照组(P<0.05).观察组术后VAS评分>4 分出现时间晚于对照组,术后 48 h内患者自控镇痛(PCA)按压次数及补救镇痛次数均少于对照组(P<0.05).术后 1、2 d,观察组RCSQ、MMSE评分均高于对照组,血清IL-6、TNF-α、CRP水平均低于对照组(P<0.05).两组围手术期不良反应发生率比较,差异无统计学意义(P>0.05).结论:喉罩浅全麻联合臂丛神经阻滞应用于老年上肢骨折手术患者,可显著减轻患者术后疼痛,改善术后睡眠质量与认知功能,抑制术后炎症反应,且不增加围手术期不良反应发生风险,安全性高、效果确切.
Objective:To explore the effects of laryngeal mask shallow general anesthesia combined with brachial plexus nerve block on postoperative pain,sleep and cognitive function in elderly patients undergoing upper fracture limb surgery,and to provide clinical reference for the selection of anesthesia in upper limb fracture surgery in elderly patients.Method:A total of 120 elderly patients who underwent upper limb fracture surgery in Lianzhou People's Hospital from April 2023 to December 2025 were selected and randomly divided into the control group(n=60)and the observation group(n=60)by the random number table method.The control group was given simple brachial plexus nerve block,while the observation group was given laryngeal mask shallow general anesthesia combined with brachial plexus nerve block.The postoperative pain indicators and sleep quality[Richards-Campbell sleep questionnaire(RCSQ)score],cognitive function[mini-mental state examination(MMSE)score],levels of serum inflammatory factors(IL-6,TNF-α,CRP),and incidence of perioperative adverse reactions of the two groups were compared.Result:In this study,2 cases in the control group were excluded due to changes in the anesthesia method.Eventually,there were 58 cases in the control group and 60 cases in the observation group.At 6,12,24 and 48 hours after the operation,the VAS scores of the observation group were significantly lower than those of the control group(P<0.05).The occurrence time of the VAS score>4 points after surgery in the observation group was later than that in the control group,the number of patient controlled analgesia(PCA)compressions and the number of remedial analgesia within 48 hours after surgery in the observation group were both less than those in the control group(P<0.05).At 1,2 days after the operation,the RCSQ and MMSE scores of the observation group were higher than those of the control group,and the levels of serum IL-6,TNF-α and CRP were lower than those of the control group(P<0.05).There was no statistically significant difference in the incidence of perioperative adverse reactions between the two groups(P>0.05).Conclusion:The application of laryngeal mask shallow general anesthesia and brachial plexus nerve block in elderly patients undergoing upper limb fracture surgery can significantly alleviate postoperative pain,improve postoperative sleep quality and cognitive function,inhibit postoperative inflammatory responses,and does not increase the risk of perioperative adverse reactions,it is highly safe and effective.
邓建华;李念红;冯卫荣;黄文斌
连州市人民医院麻醉科 广东 连州 513400连州市人民医院麻醉科 广东 连州 513400连州市人民医院麻醉科 广东 连州 513400连州市人民医院麻醉科 广东 连州 513400
医药卫生
喉罩浅全麻神经阻滞疼痛睡眠认知功能
Laryngeal mask shallow general anesthesiaNerve blockPainSleepCognitive function
《中国医学创新》 2026 (21)
5-10,6
清远市2022年科技计划项目(221109117680823)
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