Effects of General Anesthesia and Epidural Anesthesia on Postoperative Cognitive Function in Elderly Orthopaedic Patients
全身麻醉联合硬膜外麻醉对老年骨科患者术后认知功能的影响分析

摘要

目的 分析全身麻醉联合硬膜外麻醉对老年骨科患者术后认知功能的影响，以期为临床诊疗提供有益指导。方法 选取我院2022年8月～2023年1月收治的89例行骨科手术治疗的老年患者为对象，将44例接受全身麻醉的患者纳入对照组，另45例接受全身麻醉联合硬膜外麻醉的患者纳入观察组，比较两组患者麻醉前后各时段认知功能及麻醉药用量、苏醒时间与语言恢复时间等情况。结果 麻醉前，对照组、观察组认知功能评分分别为（28.15±0.27）分和（28.24±0.29）分，组间比较差异无统计学意义（P＞0.05）；而麻醉6h、12h、24h及72h后，对照组与观察组患者认知功能评分分别为（8.19±1.25）分、（9.69±2.58）分、（13.75±0.84）分、（19.12±0.64）分和（13.45±2.12）分、（14.25±2.42）分、（14.25±2.42）分、（23.33±0.62）分，观察组显著高于对照组，差异有统计学意义（P＜0.05）；观察组患者麻醉药用量（201.23±7.14）ml、苏醒时间（3.78±2.12）min、语言恢复时间（6.28±3.16）min，均显著少于对照组的（226.36±9.58）ml、（11.65±3.45）min和（14.55±5.12）min，差异有统计学意义（P＜0.05）。结论 在老年骨科患者手术治疗中科学应用全身麻醉联合硬膜外麻醉方案，可降低对患者时候短期认知功能的影响，缩短术后苏醒时间及语言恢复时间，具有较高临床应用价值，可成为临床中的优选麻醉方案。

Abstract

Objective To analyze the effect of general anesthesia combined with epidural anesthesia on postoperative cognitive function in elderly orthopedic patients.
Methods From August 2022 to January 2023, 89 cases of elderly patients with orthopedic surgery were treated in our hospital, 44 cases of patients with general anesthesia were included in the control group, 45 cases of patients with general anesthesia combined with epidural anesthesia were included in the observation group.
Results Before anesthesia, the scores of cognitive function of the control group and the observation group were (28.15 ± 0.27) and (28.24 ± 0.29) respectively, and there was no significant difference between the two groups (P > 0.05); after anesthesia, the scores of cognitive function of the patients in the observation group and the control group were (8.19 ± 1.25), (9.69 ± 2.58), (13.75 ± 0.84), (19.12 ± 0.64) and (13.45 ± 2.12), (14.25 ± 2.42), (14.25 ± 2.42), (23.33 ± 2.62), significantly higher than that of the control group, and the difference was significant (P < 0.05); the dosage of anesthesia of the patients in the observation group (201.23 ± 7.14), recovery time (3.78 ± 2.12), recovery time of language (6.28 ± 3.16) were significantly less than that of the control group (6.2236 ± 9.58), (65± 3.45) and (14.55 ± 5.52), with statistical significance (0.05).
Conclusion   The combination of general anesthesia and epidural anesthesia can reduce the short-term cognitive function, shorten the time of recovery and the time of language recovery. It has high clinical value.