To analyze the effects of general anesthesia and pericystic nerve block on pain relief and cognitive function in patients with femoral intertrochanteric fractures.

82 patients with intertrochanteric fracture of femur from January 2020 to March 2022 in Jianyang People's Hospital were selected. They were divided into observation group and control group according to random number table, with 41 patients in each group. Both groups of patients received surgical treatment. The observation group received general anesthesia combined with ultrasound guided pericystic nerve block, while the control group received general anesthesia. Visual analogue scale (VAS) was used to evaluate the analgesic effects of surgery, and the simple mental state rating scale (MMSE) was used to evaluate the cognitive function of patients. The mean arterial pressure (MAP), heart rate (HR) and MMSE scores, serum nerve growth factor-β (NGF-β), myelin basic protein (MBP) levels and VAS scores were compared between the two groups at different time points, and the differences of respiratory complications, vomiting, dizziness and venous thrombosis within 24 h after surgery were analyzed between the two groups.

Immediately after anesthesia, the MAP of the observation group was higher than that of the control group, while the HR was lower than that of the control group (P<0.05). 30 minutes after anesthesia, the HR of the observation group was lower than that of the control group (P<0.05), and the MAP of the observation group after surgery was lower than that of the control group (P<0.05). At 0, 3, 6, 12, and 24 hours after surgery, the VAS scores of both groups increased, but the observation group was lower than the control group (P<0.05). The MMSE scores of the observation group on the 1st and 2nd postoperative days were (26.45±1.01) and (27.09±0.92) points, respectively, while the control group was (24.32±1.21) and (25.04±1.17) points. The observation group was higher than the control group, and the difference was statistically significant (P<0.05). One day after surgery, serum NGF-β levels in both groups of patients decreased and the MBP level increased, but the control group showed more significant changes (P<0.05). 2 patients in the observation group experienced adverse reactions, with a total incidence of 4.9%. 8 patients in the control group experienced adverse reactions, with a total incidence of 19.5%. The incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05).

General anesthesia combined with pericystic nerve block has a good analgesic effect in the surgery of femoral intertrochanteric fractures, which can inhibit the decrease in NGF- β level and release of MBP, alleviate cognitive impairment caused by anesthesia, and reduce the incidence of adverse reactions.