The Effect of General Anesthesia Combined with Epidural Anesthesia and PCEA on the Early Postoperative Cognitive Function in Elderly Patients
作者单位：Department of AnesthesiologyFujian Provincial Hospital
会议名称：《中国中西医结合麻醉学会[CSIA]年会暨第二届全国中西医结合麻醉学术研讨会、江苏省中西医结合学会麻醉专业委员会成立大会》
会议日期：2015年
学科分类：1002[医学-临床医学] 100217[医学-麻醉学] 10[医学]
关 键 词：Epidural block Epidural analgesia Elderly patients Postoperative cognitive function
摘 要：Background:Postoperative cognitive dysfunction(POCD) is a common neurological complication among the elderly after major *** are marked by deficits of cognitive and memory,comprise a wide range of disorders from neurocognitive,and will resulting in significant long-term morbidity and an overall reduced quality of *** yet,the etiology of POCD is still unclearly,an association between POCD and the anesthetic methods has been *** this study,we assessed if general anesthesia combined with epidural anesthesia + PCIA can reduce the incidence of POCD among the elderly patients that aged over 65 who underwent open radical gastrectomy(ORG).Methods:90 ASA Ⅰgrade elderly patients that aged over 65 who underwent ORG from March 2014 to January 2015 were recruited in the *** to the table of random number,the patients were into three groups:individual general anesthesia + PCIA(Group A),general anesthesia combined with epidural anesthesia + PCIA(Group B) and general anesthesia combined with epidural anesthesia + PCEA(Group C).0.375%ropivacaine were administered epidural in Group B and Group *** function was assessed1 d before operation and on the 6 h,12 h,2d,3d and 5 d after operation,by the Mini-Mental State Examination test(MMSE).HR and MAP were recorded during the different peri-operative periods,i.e.10 min before induction of anesthesia(TO),1 h after skin incision(T1),1 min after abdominal closure(T2),and the moment of extubation(T3).Blood samples were collected from the central venous to detect the concentrations of serum protein S-100 P NSE by ELISA before induction and 24 h ***:There were no significant differences in age,sex,ASA grade,BMI,operation duration and pre-operative cognitive function among three *** of POCD:at 6 h and 12 h after operation,Group C was lower than Group A and Group *** 2 d postoperation,Group C was lower than Group *** 3d and 5 d postoperation,Group B and Group C were lower