全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响

目的:观察并对比全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响差异.方法:将95例骨科手术老年患者随机分为两组,对照组(n=47)行全身麻醉术,观察组(n=48)行硬膜外麻醉术,比较两组患者的麻醉前后的动脉血压与心率,睁眼、拔管及应答时间,对比麻醉前、麻醉后6h、12h、24h、72h的简易精神状况检测量表(MMSE)评分,统计两组患者的术后认知功能障碍(POCD)发生情况.结果:两组麻醉前、麻醉后术前、手术30min及手术完毕时的动脉血压、心率比较差异无统计学意义(P均>0.05);两组的睁眼、拔管及应答时间比较差异无统计学意义(P均>0.05);观察组麻醉后24h的MMSE评分高于对照组(P<0.05);观察组麻醉后6h、12h的术后POCD发生率低于对照组(P均<0.05).结论:与全身麻醉术相比,硬膜外麻醉术对老年骨科患者术后短期认知功能的影响更加轻微.

Effects of General Anesthesia and Epidural Anesthesia on Postoperative Cognitive Function in Elderly Patients with Orthopaedic Surgery

Objective:To observe and compare the general anesthesia and epidural anesthesia effects on short-term cognitive function in elderly patients with orthopaedic surgery. Methods:95 cases of orthopedic surgery elderly patients were randomly divided into two groups:control group ( n = 47) line of general anaes-thesia, the observation group ( n = 48) line of epidural anaesthesia, the anesthesia of arterial blood pressure and heart rate, open and tube drawing and response time, contrast before anesthesia, after anesthesia, 6 h, 12 h, 24 h, 72 h of simple mental health scale ( MMSE) score, statistics of two groups of patients with post-operative cognitive dysfunction ( POCD) were compared before and after anesthesia. Results:For the arterial blood pressure, heart rate, there was no significant difference between the two groups before and after anesthe-sia, during operation, 30min, and at the end of the operation ( P > 0.05);For opening eyes timing, extuba-tion and response time, there was no significant difference ( P > 0.05);The 24h score of MMSE in the obser-vation group was higher than that in the control group ( P <0.05);The POCD incidence rate of 6h and 12h in the observation group was lower than that in the control group ( P <0.05) . Conclusion:Compared with gener-al anesthesia, the effect of epidural anesthesia on postoperative cognitive function in elderly patients with De-partment of orthopedics is more slight.