Effects of different anesthesia methods on early postoperative cognition and stress response after unicompartment knee arthroplasty in elderly patients
Objective To investigate the effects of general anesthesia and combined spinal-epidural anesthesia on early postoperative cognition and stress response after unicompartment knee arthroplasty(UKA)in elderly patients.Methods A total of 90 patients with knee osteoarthritis(KOA)who underwent UKA in our hospital from March 2021 to March 2023 were selected and randomly divided into group A(45 cases,general anesthesia)and group B(45 cases,combined spinal-epidural anesthesia).The cognitive function,pain degree,knee joint function,S100-β protein,stress indexes at different time points and adverse reactions were compared between the two groups.Results At 6 h(T2),24 h(T4)and 72 h(T6)after operation,the Mini-Mental State Examination(MMSE)score of the group B was higher than that of the group A(P<0.05).At 2 h(T1)and 12 h(T3)after operation,the Numerical Rating Scale(NRS)score of resting and active states in the group B were lower than those in the group A(P<0.05);at T4,the NRS score of the group B in active state was lower than that of the group A(P<0.05).At T4,48 h after operation(T5)and T6,the Hospital for Special Surgery(HSS)score of the group B was higher than that of the group A(P<0.05).At T2,T4 and T6,the level of S100-β protein in the group B was lower than that in the group A(P<0.05).At T2,the levels of epinephrine,norepinephrine and renin in the group B were lower than those in the group A(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Combined spinal-epidural anesthesia can effectively prevent early postoperative cognitive dysfunction and reduce stress response in elderly patients undergoing UKA.
NETL
NSTL
万方数据
维普
