AIM: With population aging, hip arthroplasty among elderly patients has become increasingly common. This study investigated the effects of ultrasound-guided pericapsular nerve group block (PENG) combined with lumbar anesthesia versus general anesthesia on circulatory and respiratory stability, analgesia, cognitive function, and safety in elderly patients after hip arthroplasty. METHODS: A total of 86 patients who underwent hip arthroplasty in our hospital between June 2022 and June 2024 were retrospectively selected and divided into a control group (n = 50, general anesthesia) and an observation group (n = 36, ultrasound-guided PENG combined with lumbar anesthesia) according to different anesthesia conditions. Circulatory and respiratory indices, including mean arterial pressure, systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygenation index, and lung function, were compared between the two groups before and after surgery. Analgesia was evaluated using visual analogue scale (VAS). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) score, and the incidence of postoperative delirium (POD) was compared between the two groups. Adverse reactions related to anesthesia were also recorded. RESULTS: Mean arterial pressure, SBP, and DBP showed no significant differences between the two groups at different perioperative time points (all p > 0.05). The oxygenation index also remained stable postoperatively, with no statistically significant difference between groups. At 1, 6, and 24 hours after the operation, the incidence of adverse events in the observation group (2.78%, 8.33%, and 13.89%, respectively) was lower than in the control group (6%, 14%, and 26%). VAS scores decreased significantly over time, with a significant time effect (p 0.05). The overall incidence of adverse reactions was significantly lower in the observation group (13.89%) compared with the control group (26.00%, p < 0.05). There was no significant difference in the preoperative MMSE scores between the two groups (control group: 27.50 ± 2.10 points, observation group: 27.80 ± 1.90 points, t = 0.58, p = 0.46). The postoperative MMSE score of the observation group (27.00 ± 2.50 points) was significantly higher than that of the control group (25.20 ± 2.99 points, t = 3.13, p = 0.01). CONCLUSIONS: Ultrasound-guided PENG combined with lumbar anesthesia is a safe and effective anesthesia method for elderly patients undergoing hip arthroplasty, providing better analgesia, preserving cognitive function, and reducing adverse reactions.
He et al. (Fri,) studied this question.