Effect of epidural anesthesia combined with general anesthesia on perioperative hemodynamic changes and postoperative cognitive function in elderly patients undergoing abdominal surgery

Abstract

Abstract: Objective

To analyze the effects of epidural anesthesia combined with general anesthesia and general anesthesia on postoperative cognitive function and perioperative hemodynamic changes in elderly patients undergoing abdominal surgery.

Methods

From October 2018 to January 2020，80 elderly patients with abdominal surgery were selected. According to the group of odd-even patients，40 patients with single number were selected as the control group and 40 patients with double number as the experimental group.General anesthesia was used in the control group and epidural anesthesia combined with general anesthesia in the experimental group.HR，MAP，HS-CRP，IL-6，MMSE score change and recovery were compared between the two groups.

Results

Comparing the levels of HR and MAP in the two groups at T₁～T₄，it was found that the test group was significantly better than the control group （P< 0.05）， with statistical value.Comparison of postoperative HS-CRP，IL-6 and MMSE scores between the two groups showed that the experimental group was significantly better than the control group （P< 0.05），with statistical value.

Conclusion

The efficacy of epidural anesthesia combined with general anesthesia in elderly patients undergoing abdominal surgery is better，which can maintain the perioperative hemodynamic stability，inhibit the inflammatory response to stress，and improve the postoperative cognitive function， which is worthy of popularization and research.

Key words:senile abdominal surgery,epidural anesthesia,general anesthesia,hemodynamics,cognitive function

摘要： 目的

分析老年腹部手术患者应用硬膜外麻醉复合全身麻醉对围手术期血流动力学变化及术后认知功能的影响。

方法

于2018年10月—2020年1月，选取老年腹部手术患者80例，根据随机数字表法将患者分为对照组与试验组。对照组应用全身麻醉，试验组应用硬膜外麻醉复合全身麻醉。比较两组HR、MAP、hs-CRP、IL-6等水平、MMSE评分变化及恢复情况。

结果

两组T₁～T₄时HR、MAP等水平对比，试验组均明显优于对照组，差异有统计学意义（P< 0.05）。两组术后hs-CRP、IL-6等水平及MMSE评分对比，试验组均明显优于对照组，差异有统计学意义（P< 0.05）。

结论

老年腹部手术患者应用硬膜外麻醉复合全身麻醉的效果更好，可维持围手术期血流动力学稳定，抑制应激炎性反应，改善术后认知功能，值得推广研究。

关键词:老年腹部手术,硬膜外麻醉,全身麻醉,血流动力学,认知功能

CLC Number:

R614

Luhua MA, Changlu Zheng. Effect of epidural anesthesia combined with general anesthesia on perioperative hemodynamic changes and postoperative cognitive function in elderly patients undergoing abdominal surgery[J]. Journal of Shandong First Medical Unversity & Shandong Academy of Medical Sciences, 2021, 42(8): 625-627.

马鲁华, 郑昌露. 硬膜外麻醉复合全身麻醉对老年腹部手术患者围术期血流动力学与认知功能的影响[J]. betway必威登陆网址（betway.com ）学报, 2021, 42(8): 625-627.

Figures/Tables4

组别	T₀	T₁	T₂	T₃	T₄
试验组	87.7 ± 4.6	80.9 ± 2.4	82.4 ± 3.3	80.5 ± 2.4	84.6 ± 1.2
对照组	88.9 ± 5.7	73.5 ± 3.4	71.1 ± 3.5	96.4 ± 1.3	93.2 ± 1.8
t	0.0254	7.2014	8.6135	9.5124	6.2011
P	0.438	< 0.001	< 0.001	< 0.001	< 0.001

组别	T₀	T₁	T₂	T₃	T₄
试验组	87.7 ± 4.6	80.9 ± 2.4	82.4 ± 3.3	80.5 ± 2.4	84.6 ± 1.2
对照组	88.9 ± 5.7	73.5 ± 3.4	71.1 ± 3.5	96.4 ± 1.3	93.2 ± 1.8
t	0.0254	7.2014	8.6135	9.5124	6.2011
P	0.438	< 0.001	< 0.001	< 0.001	< 0.001

组别	T₀	T₁	T₂	T₃	T₄
试验组	98.8 ± 7.5	92.8 ± 6.5	89.8 ± 6.6	97.8 ± 6.6	94.6 ± 5.4
对照组	99.1 ± 8.5	80.5 ± 7.1	81.3 ± 6.6	112.6 ± 9.1	88.7 ± 4.2
t	0.0211	5.9632	4.9852	7.6128	6.0014
P	0.845	< 0.001	< 0.001	< 0.001	< 0.001

组别	T₀	T₁	T₂	T₃	T₄
试验组	98.8 ± 7.5	92.8 ± 6.5	89.8 ± 6.6	97.8 ± 6.6	94.6 ± 5.4
对照组	99.1 ± 8.5	80.5 ± 7.1	81.3 ± 6.6	112.6 ± 9.1	88.7 ± 4.2
t	0.0211	5.9632	4.9852	7.6128	6.0014
P	0.845	< 0.001	< 0.001	< 0.001	< 0.001

组别	n	hs-CRP（mg/L）	IL-6（pg/mL）
试验组	40	21.8 ± 3.6	9.5 ± 1.4	26.9 ± 3.7	15.7 ± 3.3
对照组	40	22.1 ± 4.3	15.5 ± 3.3	27.1 ± 4.6	20.8 ± 2.7
t		0.6532	5.6955	1.0325	6.5104
P		0.758	＜0.001	0.325	＜0.001

组别	n	hs-CRP（mg/L）	IL-6（pg/mL）
试验组	40	21.8 ± 3.6	9.5 ± 1.4	26.9 ± 3.7	15.7 ± 3.3
对照组	40	22.1 ± 4.3	15.5 ± 3.3	27.1 ± 4.6	20.8 ± 2.7
t		0.6532	5.6955	1.0325	6.5104
P		0.758	＜0.001	0.325	＜0.001

组别	n	术前	术后
试验组	40	29.5 ± 3.3	28.8 ± 1.2
对照组	40	29.2 ± 3.2	24.2 ± 1.3
t		0.0124	4.5012
P		0.659	< 0.001

组别	n	术前	术后
试验组	40	29.5 ± 3.3	28.8 ± 1.2
对照组	40	29.2 ± 3.2	24.2 ± 1.3
t		0.0124	4.5012
P		0.659	< 0.001

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