蛛网膜下隙麻醉对老年骨科患者术后早期认知功能的影响

正术后认知功能障碍(postoperative cognitive dysfunction,POCD)是手术患者术后常见的神经系统并发症~1-3]。尤其对于老年患者,POCD的发病率高、恢复慢。统计数据~4-5]显示,年龄65岁的老年患者术后POCD的发病率是年轻患者的2~10倍,可能与老年患者中枢神经系统退化、血流动力学调控能力弱有关。老年患者发生POCD易导致关节功能恢复延迟、住院时间延长、治疗费用增加,且会

Influence of Lumbar Anesthesia on Early Postoperative Cognitive Function in Elderly Patients in Department of Orthopedics

ABSTRACT Objective To evaluate the influence of lumbar anesthesia on early postoperative cognitive function in elderly patients in department of orthopedics. Methods A total of 60 elderly patients in department of orthopedics were enrolled in this study from June 2013 to June 2015 at our hospital. All patients were divided into two groups: the observation group (30 cases) and the control group (30 cases). Patients in the observation group received lumbar anesthesia, and patients in the control group received general anesthesia. The MMSE scores and the incidence of postoperative cognitive dysfunction (POCD) in both groups were recorded and compared. Results MMSE score at 1d post-operation was significantly reduced in both groups when compared with those before operation, while no differences were observed between the two groups at different time points after operation. Additionally, the incidence of POCD in both groups were decreased over time, and the incidence of POCD in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Lumbar anesthesia is effective to reduce the incidence of POCD in elderly patients receiving orthopedic surgery.