老年前列腺增生手术患者硬膜外联合全身麻醉的效果及对术后认知功能、炎症反应的影响

目的 探讨老年前列腺增生手术患者硬膜外联合全身麻醉的效果及对术后认知功能、炎症反应的影响.方法 选取行老年前列腺增生手术94例,根据麻醉方法不同分为观察组(49例)和对照组(45例)两组.两组均行经尿道等离子前列腺电切术,观察组采用硬膜外联合全身麻醉,对照组采用全身麻醉.比较两组术后睁眼时间、苏醒时间和拔管时间;术前1...

Effect of Epidural Anesthesia Combined with General Anesthesia and Its Effect on Postoperative Cognitive Dysfunction and Inflammatory Stress Response in Elderly Patients with Benign Prostatic Hyperplasia

Objective To investigate the effect of epidural anesthesia combined with general anesthesia and its effect on postoperative cognitive function and inflammatory reaction in elderly patients with benign prostatic hyperplasia(BPH).Methods A total of 94 cases of senile BPH were selected and divided into observation group(n=49)and control group(n=45)according to different anesthesia methods.Both groups were treated with transurethral plasmakinetic resection of prostate.The observation group was treated with epidural combined with general anesthesia,and the control group was treated with general anesthesia.The time of opening eyes,waking up and extubation,the changes of cognitive function[Mini Mental State Examination(MMSE)score]at 1 day before operation and at 1,3,7 d after operation,the serum levels of inflammatory factors,interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)at 1 day before operation and at 1,3,7 d after operation,and incidence of nausea and vomiting,hypotension,bradycardia,respiratory depression and drowsiness during operation and at 48 h after operation were compared between the two groups.Results The time elapsed to opening eyes,waking up and extubation in the observation group were shorter than those in the control group(P<0.01).There were significant differences in MMSE score,serum IL-6 and TNF-αlevels between the two groups at different time points before and after operation(P<0.01).Compared with those at 1 d before operation,the MMSE scores of the two groups were decreased,and the serum levels of IL-6 and TNF-αwere increased at 1 and 3 d after operation(P<0.01).Compared with those at 1 d after operation,MMSE scores were increased,and serum IL-6 and TNF-αlevels were decreased in both groups at 3 and 7 d after operation(P<0.01).Compared with those at 3 d after operation,MMSE score was increased and serum IL-6 and TNF-αlevels were decreased in both groups at 7 d after operation(P<0.01).At 1 and 3 d after operation,MMSE score of observation group was higher than that of control group,while serum IL-6 and TNF-αlevels of observation group were lower than those of control group(P<0.01).The total incidence of complications in the observation group was 16.33%,lower than 35.56%in the control group during operation and at 48 h after operation(P<0.05).Conclusion Epidural anesthesia combined with general anesthesia applied in elderly patients with BPH can shorten the time to postoperative eye opening,awakening and extubation,reduce the impact on postoperative cognitive function,inhibit the release of inflammatory factors after operation,and has good safety.