布比卡因脂质体用于收肌管阻滞对全膝关节置换术后谵妄的影响

The Effect of Bupivacaine Liposomes for Adductor Canal Block on Postoperative Delirium after Total Knee Arthroplasty

摘要: 目的：观察布比卡因脂质体用于收肌管阻滞对老年全膝关节置换术后谵妄发生率的影响。方法：选择单次腰麻下行单侧全膝关节置换手术的患者140例，年龄63~78岁，随机分为术后布比卡因脂质体神经阻滞(B组)和罗哌卡因神经阻滞(R组)组，每组70例，两组患者术毕均采用静脉自控镇痛泵。随访两组患者术后1周内谵妄的发病情况。结果：B组患者在术后第2天、第3天、第4天以及谵妄总例数均低于R组(P < 0.05)。结论：布比卡因脂质体用于收肌管阻滞能够降低老年全膝关节置换术后谵妄的发生率。

Abstract: Objective: To investigate the delirium incidence after adductor canal block with bupivacaine liposome on total knee arthroplasty (TKA). Methods: A total of 140 patients aged 63 to 78 years undergoing unilateral TKA under single-shot spinal anesthesia were randomly divided into two groups: Group B (bupivacaine liposome nerve block) and Group R (ropivacaine nerve block), with 70 patients in each group. Both groups used patient-controlled intravenous analgesia (PCIA) after surgery. The incidence of delirium within one week after surgery was followed up in both groups. Results: The incidence of delirium on postoperative day 2, day 3, and day 4, as well as the total number of delirium cases, was lower in Group B than in Group R (P < 0.05). Conclusion: Bupivacaine liposomes for adductor canal block can reduce the incidence of postoperative delirium after TKA in elderly patients.