Effects of Different Ultrasound-Guided Nerve Block Modalities on Inflammatory Stress Response in Elderly Patients after Total Hip Arthroplasty.

IF 0.9 4区医学 Q3 SURGERY Annali italiani di chirurgia Pub Date : 2024-01-01 DOI:10.62713/aic.3526

Jie Liu, Hailu Xia, Xin Liu, Jingjing Cui, Jianhua Wang, Yumo Jing

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Abstract

Aim: This study aimed to evaluate the impact of different ultrasound-guided nerve blocks on the postoperative inflammatory and stress response in elderly patients undergoing total hip arthroplasty (THA), providing a theoretical foundation for clinical application.

Methods: Elderly patients with THA who received ultrasound-guided nerve block combined with general anesthesia from June 2021 to June 2022 in the hospital were selected as a retrospective cohort study. Patients were divided into two groups based on the type of nerve block used. The observation group (n = 60) received ultrasound-guided pericapsular nerve group (PENG) block combined with femoral nerve block (FNB), while the control group (n = 60) received ultrasound-guided PENG block. The cortisol (Cor), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), visual analogue scale (VAS) scores, and pain medication consumption in both groups were compared.

Results: The observation group demonstrated significantly lower serum levels of Cor, TNF-α, and IL-6 at postoperative 1 day, 3 days and 7 days, as well as lower soluble protein-100β (S100β) levels at postoperative 1 day compared to the control group (p < 0.001). The VAS score in the observation group was significantly lower than that in the control group at postoperative 1 day, 3 days and 7 days (p < 0.001), with no significant difference in preoperative VAS score between the two groups (p > 0.05). Additionally, opioid consumption in the observation group was significantly lower than that in the control group at postoperative 48 h (p < 0.001).

Conclusions: The combination of ultrasound-guided PENG block and FNB effectively reduces postoperative pain and the inflammatory response in elderly patients undergoing THA, facilitating early recovery.

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不同超声引导神经阻滞模式对全髋关节置换术后老年患者炎症应激反应的影响

目的：本研究旨在评估不同超声引导下神经阻滞对老年全髋关节置换术（THA）患者术后炎症和应激反应的影响，为临床应用提供理论依据：选取 2021 年 6 月至 2022 年 6 月在该院接受超声引导下神经阻滞联合全身麻醉的老年全髋关节置换术患者作为回顾性队列研究对象。根据神经阻滞的类型将患者分为两组。观察组（n = 60）接受超声引导下囊周神经组（PENG）阻滞联合股神经阻滞（FNB），对照组（n = 60）接受超声引导下PENG阻滞。比较两组的皮质醇（Cor）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、视觉模拟量表（VAS）评分和止痛药用量：结果：与对照组相比，观察组术后1天、3天和7天的血清Cor、TNF-α和IL-6水平明显降低，术后1天的可溶性蛋白-100β（S100β）水平也明显降低（P＜0.001）。术后 1 天、3 天和 7 天，观察组的 VAS 评分明显低于对照组（P < 0.001），两组术前 VAS 评分无明显差异（P > 0.05）。此外，观察组在术后48 h的阿片类药物用量明显低于对照组（P < 0.001）：结论：超声引导下 PENG 阻滞和 FNB 联合治疗可有效减轻 THA 老年患者的术后疼痛和炎症反应，促进患者早日康复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annali italiani di chirurgia 医学-外科

CiteScore

0.90

自引率

12.50%

发文量

116

审稿时长

>12 weeks

期刊介绍： Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.