Effects of paravertebral muscle block assisted general anesthesia on postoperative cognitive function in older adult patients undergoing lumbar spine fracture surgery
10.3760/cma.j.cn341190-20231011-00275
- VernacularTitle:竖脊肌阻滞辅助全身麻醉对老年人腰椎骨折术后认知功能的影响
- Author:
Gaojiao ZHANG
1
;
Yi JIANG
Author Information
1. 温州市中西医结合医院麻醉科，温州 325000
- Keywords:
Spinal fractures;
Anesthesia, general;
Neuromuscular blockade;
Cognitive dysfunction;
Pain, postoperative;
Aged
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(11):1639-1643
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of paravertebral muscle block assisted general anesthesia on postoperative cognitive function in older adult patients undergoing lumbar spine fracture surgery.Methods:The clinical data of 68 older adult patients with lumbar spine fractures who underwent surgical treatment at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2022 were retrospectively analyzed. The patients were divided into a control group ( n = 34 cases) and an observation group ( n = 34 cases) depending on anesthesia methods used. The control group received general anesthesia, while the observation group received paravertebral muscle block assisted general anesthesia. Intraoperative anesthesia-related adverse reactions, postoperative pain relief, and the incidence of postoperative cognitive dysfunction were compared between the two groups. Results:The incidence of anesthesia-related adverse reactions in the observation group was 6% (2/34), which was significantly lower than that in the control group [26% (9/34), χ2 = 5.31, P = 0.022]. Compared with before anesthesia, the Numerical Rating Scale scores of both groups decreased after surgery. At 24, 48, and 72 hours after surgery, the Numerical Rating Scale scores of the observation group were (2.63 ± 0.42) points, (3.14 ± 0.55) points, and (4.35 ± 0.76) points, respectively, which were significantly lower than those of the control group [(3.52 ± 0.63) points, (4.58 ± 0.71) points, (5.83 ± 0.92) points, t = 6.85, 9.35, 7.23, all P < 0.001]. At 24, 48, and 72 hours after surgery, the frequency of rescue analgesia in the observation group was (3.42 ± 0.38), (5.40 ± 0.72), and (6.93 ± 1.07), respectively, which were significantly lower than those in the control group [(6.97 ± 0.87), (8.26 ± 1.27), and (10.38 ± 1.36), t = 21.80, 8.78, 9.02, all P < 0.001]. Compared with before anesthesia, the Mini-Mental State Examination scores in each group decreased significantly after surgery. At 24, 48, and 72 hours after surgery, the Mini-Mental State Examination scores in the observation group were (25.27 ± 1.11) points, (25.06 ± 1.01) points, and (27.50 ± 1.23) points, respectively, which were significantly higher than those in the control group [(19.40 ± 0.84) points, (23.17 ± 0.96) points, (24.60 ± 1.12) points, t = 24.59, 7.91, 10.17, all P < 0.001]. Conclusion:For older adult patients with lumbar spine fractures, the use of paravertebral muscle block assisted general anesthesia can reduce the incidence of adverse reactions associated with anesthesia during surgery, improve postoperative analgesic effect, reduce the incidence of postoperative cognitive dysfunction, and is highly safe.
