全身麻醉与椎管内麻醉对老年骨科手术患者术后认知功能的影响

Effects of General Anesthesia and Intraspinal Anesthesia on Postoperative Cognitive Function in Elderly Patients Undergoing Orthopedic Surgery

目的比较全身麻醉与椎管内麻醉对老年骨科手术患者术后认知功能的影响。方法选取2020年4月-2021年4月于我院行骨科手术的72例老年患者为研究对象,采用随机数字表法分为对照组和观察组,各36例。对照组采用全身麻醉,观察组采用椎管内麻醉,比较两组麻醉指标(麻醉起效时间、苏醒时间、睁眼时间、语言陈述时间)、认知功能评分、手术指标(手术时间、术中出血量)以及不良反应发生情况。结果观察组麻醉起效时间、苏醒时间、睁眼时间、语言陈述时间均短于对照组,差异有统计学意义(P<0.05);观察组术后1、6、24 h认知功能评分高于对照组,差异有统计学意义(P<0.05);观察组手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组不良反应总发生率为8.33%,低于对照组的19.44%,差异有统计学意义(P<0.05)。结论椎管内麻醉对老年骨科手术患者术后认知功能影响较小,且麻醉起效和术后恢复时间短、不良反应发生率低,具有应用有效性和安全性。

Objective To compare the effects of general anesthesia and intraspinal anesthesia on postoperative cognitive function in elderly patients undergoing orthopedic surgery.Methods A total of 72 elderly patients undergoing orthopedic surgery in our hospital from April 2020 to April 2021 were selected as the research objects and randomly divided into the control group and the observation group,with 36 cases in each group.The control group was given general anesthesia,and the observation group was given spinal anesthesia.The anesthesia indexes(anesthesia onset time,recovery time,eye opening time,language statement time),cognitive function score,operation index(operation time,intraoperative blood loss)and adverse reactions were compared between the two groups.Results The onset time of anesthesia,recovery time,eye opening time and language presentation time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The cognitive function scores at 1,6 and 24 h after operation in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The operation time of the observation group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group,the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 8.33%,which was lower than 19.44%in the control group,and the difference was statistically significant(P<0.05).Conclusion Intraspinal anesthesia has little effect on postoperative cognitive function in elderly patients undergoing orthopedic surgery,and the onset of anesthesia and postoperative recovery time are short,and the incidence of adverse reactions is low,which is effective and safe.