Effect of stellate ganglion block on early postoperative cognitive function in elderly patients with orthopedic surgery / 中国基层医药

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 .