Effects of different nerve blocks under ultrasound guidance on inflammatory factors and cognitive function after total hip replacement in the elderly
- VernacularTitle:超声引导下不同神经阻滞对老年髋关节置换术后炎症因子及认知功能的影响
- Author:
Hai-lu XIA
1
;
Jie LIU
1
;
Xin LIU
1
;
Jing-jing CUI
1
;
Jian-hua WANG
1
;
Yu-mo JING
1
Author Information
- Publication Type:Journal Article
- Keywords: nerve block; total hip replacement; inflammatory factor; cognitive dysfunction
- From: Journal of Regional Anatomy and Operative Surgery 2025;34(3):223-227
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the effects of different nerve blocks under ultrasound guidance on the expression of inflammatory factors after total hip replacement in the elderly,and its correlation with postoperative cognitive dysfunction(POCD).Methods A total of 100 elderly patients who underwent total hip replacement in our hospital from February to November 2023 were selected as the research objects,and they were divided into the femoral nerve block(FNB)group and the pericapsule nerve group block(PNGB)group according to different nerve block methods during the operation.The expression of inflammatory factors such as serum interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and tumor necrosis factor-β(TNF-β)1 day before surgery,6 hours after anesthesia,1 day after surgery,and 3 days after surgery of patients in the two groups were compared.The cognitive function of patients was evaluated by the mini-mental state examination(MMSE)score,and the pain of patients was evaluated by visual analogue scale(VAS)score.GEE model was used to evaluate the effects of two kinds of nerve block on the expression of inflammatory factors.Logistic regression was used to analyzed the correlation between postoperative inflammatory factors and POCD in patients.Results The levels of IL-1β,IL-6,IL-10,TNF-α and TNF-β 1 day after operation in the PNGB group were higher than those in the FNB group,and the differences were statistically significant(P<0.05).The MMSE score 1 day after surgery in the PNGB group was significantly higher than that in the FNB group(P<0.05),and the VAS score 3 days after surgery was significantly lower than that in the FNB group(P<0.05).GEE model showed that PNGB has a greater impact on IL-1β,IL-6,IL-10,TNF-α,and TNF-β.IL-1β,IL-6,IL-10,TNF-α,and TNF-β were all independently related to POCD induced by two different nerve blocks(P<0.05).Conclusion PNGB can effectively inhibit pro-inflammatory factors,reduce inflammatory stress responses,and maintain the balance of inflammatory factors.Inflammatory factors are independently related to POCD induced by different nerve blocks.With the occurrence of inflammatory stress response,the risk of POCD in patients increases.
