Effects of lumbar plexus-sciatic nerve block combined with sevoflurane on cognitive function in elderly patients after hip arthroplasty: study protocol for a prospective, single-center, open-label, randomized, controlled, clinical trial

doi:10.3969/j.issn.2095-4344.2017.11.007

Abstract

Abstract:

BACKGROUND: Elderly patients after total hip arthroplasty often suffer from postoperative cognitive dysfunction, but the precise mechanism remains unclear. Sevoflurane has been shown to regulate the expression of basic fibroblast growth factor in the brain. However, it is poorly understood whether sevoflurane can decrease cognitive dysfunction after hip arthroplasty. We assume that lumbar plexus-sciatic nerve block combined with sevoflurane can effectively decrease the incidence of cognitive dysfunction in elderly patients after hip arthroplasty.

OBJECTIVE: To investigate the effects of lumbar plexus-sciatic nerve block combined with sevoflurane on cognitive function in elderly patients after hip arthroplasty.

METHODS: A prospective, single-center, open-label, randomized, controlled, clinical trial will be finished at Qinghai University Affiliated Hospital, China. Seventy elderly patients undergoing unilateral total hip arthroplasty will be randomized into two groups. In the observation group, tracheal intubation will be conducted for general anesthesia after lumbar plexus-sciatic nerve block, accompanying sevoflurane inhalation for anesthesia maintenance. In the control group, tracheal intubation will be conducted for general anesthesia, accompanying intravenous administration of propofol for anesthesia maintenance. All patients will be followed up at 1 and 3 days after replacement. The primary outcome: Mini-Mental State Examination will be used to assess cognitive function at baseline, 1 and 3 days postoperatively. The secondary outcomes will be Montreal Cognitive Assessment, serum basic fibroblast growth factor expression at baseline, 1 and 3 days postoperatively; intraoperative blood loss and operation time; incidence of adverse effects intraoperatively, 1 and 3 days postoperatively. This trial has been approved by the Ethics Committee of Qinghai University Affiliated Hospital, China, and will be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Written informed consent will be obtained from all participants prior to the trial.

DISCUSSION: This trial will verify that lumbar plexus-sciatic nerve block combined with sevoflurane can improve cognitive dysfunction in elderly patients after hip arthroplasty, observe the changes in serum basic fibroblast growth factor level, and further explore its therapeutic mechanism.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Tissue Engineering, Hip Joint, Sciatic Nerve

CLC Number:

R318

Guo Yan-hong, A Liang-de, Jia Zhen. Effects of lumbar plexus-sciatic nerve block combined with sevoflurane on cognitive function in elderly patients after hip arthroplasty: study protocol for a prospective, single-center, open-label, randomized, controlled, clinical trial [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(11): 1675-1680.

Figures/Tables 3

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