| Abstract |
[Abstract] Objective To investigate the effect of ultrasound-guided lumbosacral plexus block on cognitive function, serum stress and inflammatory indexes after total hip arthroplasty (THR) in the elderly. Methods Sixty elderly THR patients in our hospital from April 2021 to April 2022 were selected as the study subjects. They were randomly divided into two groups. The control group was given conventional general anesthesia, and the observation group was given ultrasound-guided lumbosacral plexus block on the basis of the control group. The scores of the Mini-Mental State Examination (MMSE) were recorded before the operation, 1d, 3d, and 7d after the operation in the two groups. The levels of serum cortisol (Cor), tumor necrosis factor (TNF-α), interleukin 6 (IL-6) and other stress and inflammatory indexes were detected before surgery, 1d, 3d, and 7d after surgery. Postoperative complications such as cognitive impairment and delirium were recorded. Results The MMSE scores of the two groups at 1d and 3d after operation were significantly lower than those before operation, but the observation group was significantly higher than the control group at 1d and 3d after operation (P<0.05). There was no significant difference between the two groups at 7 days after operation and before operation, and between the two groups at 7 days after operation (P>0.05). The serum levels of Cor, TNF-α and IL-6 in the two groups were significantly higher than those before operation at 1d, 3d and 7d after operation, but the observation group was significantly lower than the control group at 1d and 3d after operation (P<0.05). There was no significant difference between the two groups at 7 days after operation (P>0.05). The incidences of postoperative cognitive dysfunction and delirium in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Ultrasound-guided lumbosacral plexus block can reduce the cognitive impairment, stress and inflammatory response in elderly patients after THR, and reduce the incidence of complications such as cognitive dysfunction and delirium.
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