Postoperative sleep quality in elderly patients
高龄患者术后睡眠质量

摘要

目的 分析讨论超声引导星状神经节阻滞（Stellate Ganglion Block ,SGB）对老年患者手术术后睡眠质量的影响效果。方法 选择2025.01-2025.06期间兰州市第二人民医院ASA分级 I～II 级，年龄 65-90 岁的 60 例行静吸复合全麻下手术的患者，使用随机数字表法将其分为 SGB 组（n=30）和对照组（n=30）。所有纳入对象接受标准气管插管静吸复合全麻。SGB组完成气管插管后在超声引导下以5ml 0.25%罗哌卡因行单次右侧 SGB,对照组无相应干预措施。记录患者术前术后的睡眠质量，观察术中患者血压（MAP）、心率（HR）、血氧饱和度（SpO2）、呼气末二氧化碳分压（PETCO2）、BIS 值，白介素-6（IL-6）、5-羟色胺（5-HT）、促肾上腺皮质激素释放激素（CRH）等血清指标，术后镇痛效果以及术后并发症发生率。结果 两组患者D0时睡眠质量差异较小（P＞0.05），D1、D2时SGB组睡眠质量优于对照组（P＜0.05）；两组患者T0时MAP、HR、SPO2、PETCO2和BIS值差异较小（P＞0.05），T1、T2时SGB组MAP、HR、SPO2、PETCO2和BIS值均优于对照组（P＜0.05）；入手术室时两组患者血清指标差异较小（P＞0.05），术后24h，SGB组IL-6、5-HT、CRH等血清指标均优于对照组（P＜0.05）；SGB组疼痛评分优于对照组（P＜0.05）；SGB组术后并发症发生率低于对照组（P＜0.05）。结论 超声引导星状神经节阻滞对老年患者手术术后睡眠质量的影响效果明显，值得广泛推广与应用。

Abstract

Objective To analyze and discuss the effect of ultrasound-guided Stellate Ganglion Block (SGB) on postoperative sleep quality in elderly patients.
Methods Sixty patients aged 65-90 with ASA grades I-II and undergoing surgery under combined general anesthesia at the Second People's Hospital of Lanzhou City from January to June 2025 were selected and randomly divided into an SGB group (n=30) and a control group (n=30) using a random number table method. All included subjects received standard endotracheal intubation combined with general anesthesia. After completing tracheal intubation, the SGB group underwent a single right SGB with 5ml of 0.25% ropivacaine under ultrasound guidance, while the control group did not receive any corresponding intervention measures. Record the patient's sleep quality before and after surgery, observe the patient's blood pressure (MAP), heart rate (HR), blood oxygen saturation (SpO2), end expiratory carbon dioxide partial pressure (PETCO2), BIS value, serum indicators such as interleukin-6 (IL-6), serotonin (5-HT), and corticotropin releasing hormone (CRH) during surgery, postoperative analgesic effect, and incidence of postoperative complications.
Results There was little difference in sleep quality between the two groups of patients at D0 (P>0.05), while the sleep quality of the SGB group was better than that of the control group at D1 and D2 (P<0.05); The differences in MAP, HR, SPO2, PETCO2, and BIS values between the two groups of patients at T0 were small (P>0.05), while at T1 and T2, the MAP, HR, SPO2, PETCO2, and BIS values in the SGB group were better than those in the control group (P<0.05); When entering the operating room, there was a small difference in serum indicators between the two groups of patients (P>0.05). 24 hours after surgery, serum indicators such as IL-6, 5-HT, and CRH in the SGB group were better than those in the control group (P<0.05); The pain score of the SGB group was better than that of the control group (P<0.05); The incidence of postoperative complications in the SGB group was lower than that in the control group (P<0.05).
Conclusion   Ultrasound guided stellate ganglion block has a significant impact on postoperative sleep quality in elderly patients and is worthy of widespread promotion and application.