Volume 21 Issue 11
Nov.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(11): 1868-1871
WANG Binhong, QIN Jinling. Study on the effect of ultrasound-guided stellate ganglion block for preventing cognitive impairment after hip fracture surgery in the elderly[J]. Chinese Journal of General Practice, 2023, 21(11): 1868-1871. doi: 10.16766/j.cnki.issn.1674-4152.003245
Citation: WANG Binhong, QIN Jinling. Study on the effect of ultrasound-guided stellate ganglion block for preventing cognitive impairment after hip fracture surgery in the elderly[J]. Chinese Journal of General Practice, 2023, 21(11): 1868-1871. doi: 10.16766/j.cnki.issn.1674-4152.003245
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Study on the effect of ultrasound-guided stellate ganglion block for preventing cognitive impairment after hip fracture surgery in the elderly

doi: 10.16766/j.cnki.issn.1674-4152.003245
  • 1.

    Department of Anesthesiology, Xinchang Hospital Affiliated to Shaoxing University of Arts and Sciences, Shaoxing, Zhejiang 312500, China

Funds:

 2018ZH028

  • Received Date: 2023-07-20
    Available Online: 2024-01-13
    Abstract
  •   Objective  Elderly patients have a higher risk of postoperative cognitive dysfunction (POCD), and this study investigates the improvement effect of ultrasound-guided stellate ganglion block (SGB) on cognitive function after hip fracture surgery in the elderly in order to improve the patient's prognosis.  Methods  A total of 170 elderly patients who underwent hip fracture surgery at Xinchang Hospital Affiliated to Shaoxing University of Arts and Sciences from May 2019 to May 2023 were randomly divided to a control group (85 cases) and a study group (85 cases) by random number table method. The control group underwent total hip replacement surgery under general anesthesia, and the study group received ultrasound guided SGB intervention before anesthesia induction. The surgical and anesthesia recovery indicators were recorded. The changes in hemodynamic indicators during anesthesia were monitored. The brain oxygen metabolism indicators and brain injury biochemical indicators were analyzed, and the occurrence of POCD 3 days after surgery were calculated.  Results  There was no statistically significant difference in intraoperative bleeding volume, surgical duration, postoperative recovery time, and extubation time between the two groups (all P > 0.05). The heart rate (HR), mean arterial pressure (MAP) values during skin incision and 60 minutes after surgery in both groups were significantly lower than those after admission (all P < 0.001). Immediately after surgery, the cerebral oxygen uptake rate values in the study group [(28.93±2.79)%] were significantly lower than that in the control group [(31.29±2.56)%], while the cerebral venous oxygen content, regional cerebral oxygen saturation and cerebral blood flow/cerebral metabolic rate of oxygen values [(110.78±5.66) mL/L, (61.94±3.78) min, 16.22±1.16] were significantly higher than those in the control group [(104.39±5.92) mL/L, (57.62±3.64) min, 15.09±1.03, all P < 0.001]. The content of serum S-100β and neuron specific enolase at 3 days after surgery in the study group were significantly lower than the control group (all P < 0.001). The incidence of POCD at 3 days after surgery in the study group (8.24%, 7/85) was significantly lower than that in the control group (22.35%, 19/85, χ2=6.538, P=0.011).  Conclusion  Ultrasound guided SGB can improve brain tissue oxygen supply and metabolic function in elderly patients undergoing hip fracture surgery, alleviate brain injury, and reduce the risk of POCD.

     

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