The effect of ultrasound-guided PENG block combined with epidural anesthesia on elderly patients undergoing femoral head replacement surgery
LAI Guangyi
ZOU Dajing
LU Yanping
YI Mingliang
Abstract：Objective To explore the effects of ultrasound-guided pericapsular nerve group(PENG)block of the hip joint combined with epidural anesthesia on the anesthetic effect,postoperative cognitive function and immune function in elderly patients undergoing femoral head replacement surgery.Methods A total of 120 elderly patients,aged＞60 years,of American Society of Anesthesiologists(ASA)physical status classification Ⅰor Ⅱ,who underwent femoral head replacement surgery at Chengdu Hospital of Integrated Traditional Chinese and Western Medicine from June 2021 to July 2024 were selected.The patients were randomly divided into the control group(n=60)and the study group(n=60)using a random number table method.The study group received ultrasound-guided PENG block combined with epidural anesthesia,while the control group only received epidural anesthesia.The hemodynamic indicators(heart rate,mean arterial pressure),immune function[CD4+,CD4+/CD8+,regulatory T cells(CD4+CD25+)],mini mental state examination score(MMSE),incidence of postoperative cognitive dysfunction(POCD),visual analogue scale(VAS)were compared between the two groups.Results The fluctuation of heart rate and mean arterial pressure in the study group was lower than that in the control group after anesthesia(P＜0.05).The research group exhibited elevated CD4+and CD4+/CD8+ratios but reduced CD4+CD25+levels at 6,24,72 h postoperatively versus the control group(P＜0.05).Compared with the control group,the research group demonstrated higher MMSE scores at 6,24,48 h post-operatively and lower POCD incidence at 6,24 h after the operation(P＜0.05).Compared with the control group,the research group showed reduced VAS scores at 30 min and 2 h after the operation,(P＜0.05);there was no statistically significant difference in VAS scores between the two groups at 24 h after the operation(P＞0.05).Conclusion Ultrasound guided PENG block combined with epidural anesthesia is more effective,with good analgesic effects,which is conducive to reducing the impacts on hemodynamics and immune function,enhancing faster cognitive recovery,and reducing the incidence of postoperative cognitive dysfunction.
Keywords：ultrasound-guided pericapsular nerve group blockepidural anesthesiafemoral head replacement surgerycognitive functionimmune function
Publication Date：2025-12-15
Online Publishing Date：2025-12-19(First online date of this platform, not the publication date of the document)
Pages：6( 483-488 )