The effect of epidural anesthesia and general anesthesia on postoperative cognitive function in elderly patients

Objective To study the clinical significance of epidural anesthesia and general anesthesia on postoperative cognitive function in elderly patients.Methods Randomly selected 150 elderly(≥65 years) patients,who were in accordance with the ASA I-Ⅱ grade,non-serious cardiovascular and cerebrovascular diseases,no significant respiratory and circulatory system diseases,neuropsychiatric system function without taking affect drug elective major orthopedic surgery,according to the different anesthesia methods,patients were averagely divided into epidural anesthesia(epidural group) and general anesthesia(general anesthesia group).Mean arterial blood pressure(BP) and heart rate(HR) were recorded at different points,using the Mini-Mental State Examination(MMSE) to determine the cognitive functions of the two groups patients at different time,the maximum score was 30 points,and the score less than 23 points could be considered the cognitive dysfunction(POCD).Results The arterial BP and HR of the two groups patients before anesthesia,after anesthesia before surgery,surgery 30 min,the main surgical steps and the end of surgery,were no significant difference(P0.05);Anesthesia after 24 h,the epidural group MMSE score was significantly higher than the general anesthesia group(P0.05),and no statistically significant difference in the rest of the time(P0.05).The incidence of cognitive dysfunction after anesthesia 6 h and 12 h of the epidural group were 13.3% and 6.7%,which was lower than the general anesthesia group included 24.0% and 20.0%,the difference were statistically significant(P0.05).Conclusion Elderly patients in early postoperative epidural anesthesia and general anesthesia both can suffer POCD,while general anesthesia is more obvious in the postoperative effect of 24 h on the cognitive function in elderly patients than epidural anesthesia.