Effects of Different Anesthesia Methods on Postoperative Cognitive Function in Elderly Patients Undergoing Lower Limb Fracture Surgery
娄保锋 1任晶2
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作者信息
1. 261042 山东潍坊,潍坊市第二人民医院麻醉科
2. 261042 山东潍坊,潍坊市第二人民医院呼吸二部
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摘要
目的 比较老年下肢骨折手术患者采取全身麻醉和硬膜外麻醉后,对患者术后认知功能及手术相关指标的影响.方法 收集2022年4月至2024年4月于潍坊市第二人民医院接受下肢骨折手术的100例老年患者,根据麻醉方式的不同分为硬膜外麻醉组和全身麻醉组,每组各50例.比较两组患者手术相关指标、认知功能、术后并发症.结果 硬膜外麻醉组患者手术时间长于全身麻醉组(P＜0.001),但麻药用量显著少于全身麻醉组(P＜0.001),且睁眼时间、言语应答时间、住院时间均显著短于全身麻醉组(P＜0.001).术后6h、12h、24h硬膜外麻醉组患者简易精神状态检查量表(Mini Mental Status Examination,MMSE)评分显著高于全身麻醉组患者(P＜0.05).硬膜外麻醉组患者术后并发症总发生率为8.00％,显著低于全身麻醉组的24.00％,差异有统计学意义(P＜0.05).结论 对于下肢骨折手术的老年患者,采取硬膜外的麻醉方式不仅镇痛效果良好,而且对认知功能影响小,有利于术后恢复.
Abstract
Objective To compare the effects of general anesthesia and epidural anesthesia on postopera-tive cognitive function and surgical-related indicators in elderly patients undergoing lower limb fracture surgery.Methods A total of 100 elderly patients who underwent lower limb fracture surgery at Weifang Second People's Hospital from June 2022 to June 2024 were collected.Based on the type of anesthesia,patients were divided into an epidural anesthesia group(n=50)and a general anesthesia group(n=50).Surgical-related indicators,cognitive function,and postoperative complications were compared between the two groups.Results The surgery dura-tion in the epidural anesthesia group was longer than that in the general anesthesia group(P＜0.00l),but the amount of anesthetic used was significantly less(P＜0.001).Additionally,the time to eye-opening,verbal response time,and length of hospital stay were significantly shorter in the epidural anesthesia group compared to the general anes-thesia group(P＜0.001).At 6,12,and 24 hours postoperatively,the MMSE scores in the epidural anesthesia group were significantly higher than those in the general anesthesia group(P＜0.05).The overall incidence of postopera-tive complications in the epidural anesthesia group was 8.00％,significantly lower than the 24.00％in the general anesthesia group(P＜0.05).Conclusion For elderly patients undergoing lower limb fracture surgery,epidural anesthesia provides effective pain relief,has a minimal impact on cognitive function,and promotes postoperative recovery.
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