Effects of Transversus Abdominis Plane Block and Patient Controlled Intravenous Analgesia on Cognitive Function and Early Recovery in Elderly Patients Undergoing Laparoscopic Surgery

Abstract

Objective: To study and analyze the effects of transversus abdominis plane block (TAPB) and patient controlled intravenous analgesia (PCIA) on cognitive function and early rehabilitation in elderly patients undergoing laparoscopic surgery. Methods: 100 elderly patients undergoing elective laparoscopic surgery in our hospital from October 2020 to May 2023 were selected and divided into study group and control group by random number table method, with 50 cases in each group. Patients in both groups were given general anesthesia during the operation, patients in the control group received PCIA intervention, and patients in the study group received postoperative transversal muscle plane block combined with controlled intravenous analgesia. Postoperative pain and agitation, perioperative cognitive function at different stages, and early postoperative rehabilitation were evaluated and compared between the two groups. Results: VAS scores in the study group were lower than those in the control group at 12h and 36h after surgery, and the incidence of agitation was lower than that in the control group, with statistical differences (P < 0.05). There was no statistical difference in MMSE scores between the two groups 24 hours before surgery (P < 0.05), and the MMSE scores in the study group were higher than those in the control group 24 hours and 72 hours after surgery, with statistical significance (P < 0.05). The time of first feeding, leaving bed, exhaust gas, defecation and perioperative hospital stay in the study group were shorter than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion: The combined application of TAPB and PCIA in elderly patients undergoing laparoscopic surgery can enhance the postoperative analgesia effect, reduce the incidence of agitation, improve early postoperative cognitive function, and promote early rehabilitation.