Comparative Study on the Effect of Spinal Anesthesia and Epidural Anesthesia on Short Term Cognitive Function and Stress Response in the Elderly Patients after Orthopedic Surgery
Objective:To compare the influence of spinal anesthesia(SA)and epidural anesthesia(EA)on short term cognitive function and stress response of the elderly patients after orthopedic surgery.Method:From February 2019 to February 2021,100 elderly patients who underwent orthopedic surgery in Linyi Central Hospital were divided into the group SA(n=50)and the group EA(n=50)according to the random number table method.The mini mental state examination(MMSE)scores before and after operation,the occurrence of post-operative cognitive dysfunction(POCD),the levels of angiotensin Ⅱ(AngⅡ),cortisol(Cor),adrenocorticotropic hormone(ACTH),systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)in two groups were compared.Result:Compared with the preoperative,the MMSE scores of the two groups decreased at 3,12,24 hours after operation,MMSE scores at 3,12 and 24 hours after operation in group EA were significantly lower than those in group SA(P<0.05);compared with group EA(20.00%),the incidence of POCD in group SA(6.00%)was significantly lower(P<0.05);compared with the preoperative,the levels of AngⅡ,Cor and ACTH in the two groups were significantly increased after operation,and those in the group SA were significantly lower than those in the group EA(P<0.05);compared with the preoperative,SBP,DBP and HR of the two groups after operation were significantly lower,the differences were statistically significant(P<0.05),but the differences between the two groups were not statistically significant(P>0.05).Conclusion:Compared with EA,SA has less effect on short term cognitive function after orthopedic surgery in elderly patients,but also can reduce the stress response of surgery,both of them have a similar effect on hemodynamics,which is worth clinical reference.
Spinal anesthesiaEpidural anesthesiaElderly patientsOrthopedic surgeryCognitive function Stress response
万方数据
维普
