全麻和硬膜外麻醉对老年患者骨科手术后认知功能的影响

目的探讨全身麻醉和硬膜外麻醉对老年骨科患者术后24 h内认知功能的影响。方法选择梅州市人民医院自2009年8月至2012年8月收治的骨科手术患者158例,按照随机数字表法分为两组:全身麻醉80例作为研究组,硬膜外麻醉78例作为对照组。分别将术前、术中、术后的平均动脉压和心率进行比较;同时使用简易智力状态(MMS)评分对患者的认知功能情况进行判定并对比。结果两组患者术前、术中、术后的平均动脉压和心率比较,差异均无统计学意义(P>0.05);与术前比较,术后6、12、24 h两组MMS分值均有不同程度的降低,且研究组的MMS分值较对照组偏低,差异有统计学意义(P<0.05)。结论全身麻醉和硬膜外麻醉均会对老年骨科患者术后短期内的认知功能产生影响,但全身麻醉的影响较大。

Impact of General Anesthesia and Epidural Anesthesia on Short-term Cognitive Function in Elderly Patients after Orthopedic Surgery

Objective To investigate the impact of general anesthesia and epidural anesthesia on cognitive function in elderly orthopedic patients within 24 hours after orthopedic surgery.Methods One hundred and fifty-eight patients undergoing orthopedic surgery at Meizhou City People's Hospital from August 2009 to August 2012 were divided according to the random number table,80 cases with general anesthesia as research group,78 cases of epidural anesthesia as control group.Preoperative,intraoperative and postoperative mean arterial pressure and heart rate were compared.Cognitive function of patients was determined using MMS score and compared.Results As for the preoperative,intraoperative and postoperative mean arterial pressure and heart rate in the two groups,there were no statistically significant difference(P > 0.05).Compared with the preoperative,6,12,24 h postoperative MMS scores of the two groups were significantly lower,and the scores of the research group were lower than the control group with statistically significant difference(P < 0.05).Conclusion Both general anesthesia and epidural anesthesia have short-term impacts on cognitive function in elderly patients after orthopedic surgery,but the impact of general anesthesia is greater.