Measurements
postoperative nausea and vomiting [PONV, swelling, toxicity, POCD, painless, pain, PONV, hematoma, urinary retention
DEEP VEIN THROMBOSIS, ADVERSE EFFECTS, SECONDARY, STERILE, HEMATOMA
The primary outcome measure was the frequency (in %) of the occurrence of POCD, defined according to changes in the MoCA scores. The secondary outcome measures were VAS scores at rest and BCS scores 6 h (t1), 12 h (t2), 24 h (t3), and 48 h (t4) after surgery; the plasma levels of HMGB1 and IL-6; the requirement for rescue analgesia; the time to first off-bed activity; and adverse effects after surgery (postoperative nausea and vomiting [PONV], urinary retention, wound swelling, deep vein thrombosis, hematoma, and LA systemic toxicity [LAST]).All patients received the neuropsychological test in a quiet environment by a well-trained anesthesiologist using the MoCA one day preoperatively, seven and 30 days postoperatively. The MoCA [The pain scores on the visual analog scale (VAS) (0, no pain, 10 excruciating pain) at rest, and comfort scores on the Bruggrmann comfort scale (BCS) (0, continuous pain; 1, painless at rest, severe pain while deep breathing or coughing; 2, painless at rest, slight pain while deep breathing or coughing; 3, painless when deep breathing; 4, painless when coughing) was measured 6 h (t1), 12 h (t2), 24 h (t3), and 48 h (t4) after surgery. The requirement for rescue analgesia was also recorded 48 h after surgery.Venous blood samples (5 mL) were collected from all patients 1 h preoperatively (baseline) and 24 h postoperatively (day 1). The samples were put into sterile heparin tubes immediately and centrifuged at 1000×g for 15 min at 4 °C, and the plasma was extracted and stored at − 80 °C for future assays. The plasma concentrations of HMGB1 and IL-6 were tested by a professional biotechnology company (Animalunion Biotechnology Co., Ltd., Shanghai, China) using the ELISA method.In addition, the time to first off-bed activity from the end of surgery, and patients’ self-reported adverse effects (PONV, urinary retention, wound swelling, deep vein thrombosis, hematoma, and LAST) were also recorded 24 h after surgery. All clinical data were collected by staff unaware of the patient’s grouping.