全麻与硬膜外麻醉对老年骨科患者术后短期认知功能的影响

Comparative analysis of the impact on cognitive function of anesthesia and epidural anesthesia in elderly patients after orthopedic term

目的比较全麻与硬膜外麻醉对老年骨科患者术后短期认知功能的影响。方法将80例老年骨科患者按照抽签方法随机分为对照组与观察组各40例,对照组行全麻,观察组行硬膜外麻醉,比较两组动脉血压及脉搏、睁眼时间、拔管时间、应答时间及手术前后认知功能评分。结果两组患者麻醉前、麻醉后术前、手术0.5 h、手术操作时以及手术结束时动脉血压及脉搏相比,差异均无统计学意义(P>0.05);两组患者的睁眼时间、拔管时间、应答时间相比,差异均无统计学意义(P>0.05);两组术前0.5 h认知功能评分差异无统计学意义(P>0.05),观察组术后6 h、24 h及72 h认知功能评分均显著大于对照组(P<0.05)。结论与全麻相比,硬膜外麻醉对老年骨科患者术后短期认知功能的影响较小,因此,硬膜外麻醉更适合临床广泛推广应用。

Objective To compare cognitive function of anesthesia and epidural anesthesia in elderly patients after or- thopedic term. Methods A total of 80 cases of elderly orthopedic patients according to balloting were randomly divided into control group and observation group ,40 cases each group. Control group underwent general anesthesia, observation group underwent epidural anesthesia. Arterial blood pressure and pulse and eye opening,extubation time,response time and postoperative cognitive function scores were compared, Results Two groups of patients before anesthesia, anesthesia preoperative,operative,0.5 h, surgical operation, as well as the end of surgery arterial blood pressure and pulse ,the dif- ference was not statistically significant （P 〉 0.05 ）;Two group of eye opening,extubation time ,response time ,the differ- ence was not statistically significant （P 〉 0.05）;Preoperative 0.5 h cognitive function scores showed no significant dif- ference （P 〉 0.05）,observation group after 6 h,24 h and 72 h cognitive function scores were significantly higher than the control group （P 〈 0.05）. Conclusion Compared with general anesthesia, anesthesia in elderly die outside orthope- dic patients less short-term cognitive function, therefore, is more suitable for die outside anesthesia applications.