ABSTRACT
Objective To investigate the effect of stellate ganglion block ( SGB ) on early postoperative cognitive function in elderly patients undergoing orthopedic surgery .Methods 115 elderly patients with orthopedic surgery were selected as study objects ,and they were randomly divided into observation group (55 cases) and control group(60 cases) according to the digital table .The observation group received epidural anesthesia after SGB ,while the control group only received routine epidural anesthesia .Preoperation and postoperative 6h,3d and 7d,the mini mental state examination ( MMSE ) scores were measured and compared , the cognitive function was assessed .The MMSE score and postoperative cognitive dysfunction ( POCD) occurrence before and after surgery in the two groups were compared.Results In the observation group,the preoperative MMSE score was (29.36 ±2.54) points,the MMSE scores of 6h,3d and 7d after operation were (22.69 ±3.01) points,(25.33 ±2.69) points,(28.32 ± 3.04)points,respectively.The difference between preoperation and postoperation was statistically significant ( F =51.26,P <0.05).In the control group,the MMSE scores of before surgery and 6h,3d,7d after surgery were (29.69 ±2.17)points,(20.24 ±3.59)points,(21.87 ±2.02)points and (27.66 ±3.07)points,respectively,the difference was statistically significant (F=103.70,P<0.05).Before surgery,the MMSE score between the observa-tion group and control group had no statistically significant difference .6h and 3d after surgery,the MMSE scores of the observation group were higher than those of the control group (t=3.947,7.745,all P<0.05);7d after operation,the MMSE score between the two groups had no statistically significant difference (P>0.05).6h after surgery,the inci-dence rate of POCD of the observation group was 3.64％,which of the control group was 11.67％.3d after operation, the incidence rate of POCD was 1.82％ in the observation group and 3.33％ in the control group.There was no statistically significant difference in the incidence of POCD between the two groups at 6 and 3d after operation ( P>0.05).7d after operation,POCD was not detected in the observation group ,and the incidence rate of the control group was 3.33％.The total incidence rate of POCD was 5.45％ in the observation group and 18.33％ in the control group,and the incidence rate of the observation group was lower (χ2 =4.452,P<0.05).Conclusion SGB can improve the cognitive function of elderly patients after orthopedic surgery ,and it is worthy of clinical recommendation .
ABSTRACT
Objective To investigate the effect of stellate ganglion block combined with morphine sustainedrelease tablets for controlling pain of advanced lung cancer.Methods 90 cases with advanced lung cancer were randomly divided into the observation group and control group with 45 cases in each group.The control group was givenmorphine sustained-release tablets,the observation group received combination therapy with stellate ganglion block and morphine sustained-release tablets.The analgesic effects,quality of life scores and adverse reactions of two groups were compared.Results The effective rate of observation group was 93.33 ％ (42/45),which was significantly higher than that of control group 77.78％ (35/45),the difference was statistically significant (x2 =4.54,P ＜ 0.05).The morphine consumption of observation group was significantly less than that of control group(t =9.11,P ＜ 0.05),duration of analgesia was significantly longer than that of control group (t =6.72,P ＜ 0.05).Quality of life score in the observation group was significantly higher than that in the control group,the difference was statistically significant(Z =3.61,P ＜ 0.05).The incidence rate of adverse reactions was 17.78％ (8/45),which was significantly lower than that of the control group 46.67％ (21/45),the difference was statistically significant (x2 =4.54,P ＜ 0.05).Conclusion Stellate ganglion block combined with morphine sustained-release tablets for controlling pain of advanced lung cancer can significantly improve analgesia,reduce morphine consumption and adverse reactions,is worthy of clinical application.