A observation of early postoperative cognitive dysfunction and postoperative analgesia situation after intercostal nerve block was applied on elderly patient received thoracic surgery / 中国医学装备

ABSTRACT

Objective:To investigate the effect of early postoperative cognitive dysfunction and postoperative analgesia situation after intercostal nerve block was applied on elderly patient received thoracic surgery.Methods: 105 elderly patients underwent thoracic surgeries were divided into observation group (35 patients received intercostal nerve block combined with general anesthesia), control A group (35 patients received epidural anesthesia combined with general anesthesia) and control B group (35 patients received routine general anesthesia). The cognitive function, postoperative pain, intraoperative mean artery pressure (MAP) and heart rate of the patients among different groups were respectively compared.Results: The cognitive function scores in postoperative 12h, 24h, 72h of observation group were significantly higher than that of control A group (t=20.917,t=27.780, t=74.081,P<0.05), respectively. And all of these data also were significantly higher than that of control B group (t=37.922,t=48.969,t=62.653,P<0.05), respectively. The differences of MAP, HR value between observation group and control A group were statistically significant (t=18.927,t=22.380,P<0.05), respectively. And the differences of them between observation group and control B group also were statistically significant (t=31.051, t=19.932, P<0.05), respectively. Besides, the differences of pain scores in postoperative 6h, 12h, 24h, 48h between observation group and control A group were not statistically significant, while all of pain scores of observation group were significantly lower than that of control B group (t=18.731,t=19.035, t=21.093,t=17.036;P<0.05).Conclusion:Intercostal nerve block combined with general anesthesia can ensure more stable intraoperative vital signs for elderly patients underwent thoracic surgeries, and it contributes to improve early cognitive function and possesses better postoperative analgesic effect for elderly patients.