Tianjin Hospital.
Cell Mol Biol (Noisy-le-grand). 2022 Feb 28;68(2):103-108. doi: 10.14715/cmb/2022.68.2.15.
The study aimed to investigate the effects of different anesthesia methods on the analgesia, inflammation and oxidative stress levels and cognitive function in elderly patients undergoing hip replacement. 100 elderly patients requiring hip replacement and admitted to Tianjin Hospital from March 2017 to March 2019 were enrolled and divided into group A (n=35, general anesthesia with endotracheal intubation), group B (n=35, epidural anesthesia) and group C (n=30, general anesthesia with endotracheal intubation + epidural anesthesia). The basic vital signs, inflammatory factors, stress response indicators and cognitive function changes were compared among three groups. Additionally, the effects of three different anesthesia methods were analyzed based on the differences in postoperative analgesic effect, extubation time and recovery time. The vital signs [systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR)] were lower in group C than those in group A and group B after surgery (p<0.05). The VAS score at 12 h and 24 h after surgery was lower than that at 3 h after surgery (p<0.05). Group A and B had increased levels of these inflammatory factors after surgery compared with those before surgery. Postoperative extubation time, eye-opening time upon calling and recovery time were significantly shorter in group C than those in groups A and B (p<0.05). The oxidative stress indexes in group C were remarkably lower than those in groups A and B (p<0.05). The MMSE score was decreased in groups A and B after surgery compared with that before surgery (p<0.05). General anesthesia combined with epidural anesthesia applied in elderly patients undergoing hip replacement achieves a good anesthetic effect and is able to stabilize the vital signs and stress levels of patients and improve postoperative analgesic effect and cognitive function, which is worthy of popularization in clinical practice.
本研究旨在探讨不同麻醉方法对老年髋关节置换患者的镇痛效果、炎症和氧化应激水平及认知功能的影响。选择 2017 年 3 月至 2019 年 3 月在天津市医院行髋关节置换术的 100 例老年患者为研究对象，分为 A 组（n=35，气管插管全身麻醉）、B 组（n=35，硬膜外麻醉）和 C 组（n=30，气管插管全身麻醉+硬膜外麻醉）。比较三组患者的基本生命体征、炎症因子、应激反应指标及认知功能变化，分析三种不同麻醉方法的效果差异。结果显示，术后 C 组患者的生命体征（收缩压、舒张压和心率）低于 A 组和 B 组（p<0.05），术后 12 h 和 24 h 的 VAS 评分均低于术后 3 h（p<0.05）。与术前相比，A 组和 B 组患者术后炎症因子水平升高。与 A 组和 B 组相比，C 组患者术后拔管时间、睁眼时间和恢复时间更短（p<0.05）。与 A 组和 B 组相比，C 组患者的氧化应激指标显著降低（p<0.05）。与术前相比，A 组和 B 组患者术后 MMSE 评分降低（p<0.05）。综上所述，全身麻醉联合硬膜外麻醉应用于老年髋关节置换术患者，可取得良好的麻醉效果，稳定患者生命体征和应激水平，提高术后镇痛效果和认知功能，值得在临床实践中推广。
