麻醉安全与质控2025，Vol.7Issue(6)：483-488,6.DOI:10.3969/j.issn.2096-2681.2025.06.007
超声引导下PENG阻滞联合硬膜外麻醉对老年股骨头置换术的影响
The effect of ultrasound-guided PENG block combined with epidural anesthesia on elderly patients undergoing femoral head replacement surgery
摘要
Abstract
Objective To explore the effects of ultrasound-guided pericapsular nerve group(PENG)block of the hip joint combined with epidural anesthesia on the anesthetic effect,postoperative cognitive function and immune function in elderly patients undergoing femoral head replacement surgery.Methods A total of 120 elderly patients,aged＞60 years,of American Society of Anesthesiologists(ASA)physical status classification Ⅰor Ⅱ,who underwent femoral head replacement surgery at Chengdu Hospital of Integrated Traditional Chinese and Western Medicine from June 2021 to July 2024 were selected.The patients were randomly divided into the control group(n=60)and the study group(n=60)using a random number table method.The study group received ultrasound-guided PENG block combined with epidural anesthesia,while the control group only received epidural anesthesia.The hemodynamic indicators(heart rate,mean arterial pressure),immune function[CD4+,CD4+/CD8+,regulatory T cells(CD4+CD25+)],mini mental state examination score(MMSE),incidence of postoperative cognitive dysfunction(POCD),visual analogue scale(VAS)were compared between the two groups.Results The fluctuation of heart rate and mean arterial pressure in the study group was lower than that in the control group after anesthesia(P＜0.05).The research group exhibited elevated CD4+and CD4+/CD8+ratios but reduced CD4+CD25+levels at 6,24,72 h postoperatively versus the control group(P＜0.05).Compared with the control group,the research group demonstrated higher MMSE scores at 6,24,48 h post-operatively and lower POCD incidence at 6,24 h after the operation(P＜0.05).Compared with the control group,the research group showed reduced VAS scores at 30 min and 2 h after the operation,(P＜0.05);there was no statistically significant difference in VAS scores between the two groups at 24 h after the operation(P＞0.05).Conclusion Ultrasound guided PENG block combined with epidural anesthesia is more effective,with good analgesic effects,which is conducive to reducing the impacts on hemodynamics and immune function,enhancing faster cognitive recovery,and reducing the incidence of postoperative cognitive dysfunction.关键词
超声引导下PENG阻滞/硬膜外麻醉/股骨头置换术/认知功能/免疫功能Key words
ultrasound-guided pericapsular nerve group block/epidural anesthesia/femoral head replacement surgery/cognitive function/immune function引用本文复制引用
赖广益,邹妲婧,陆燕萍,易明亮..超声引导下PENG阻滞联合硬膜外麻醉对老年股骨头置换术的影响[J].麻醉安全与质控,2025,7(6):483-488,6.基金项目
四川省卫生健康科研课题(20SYJS26) （20SYJS26）
