Influence of epidural block and general anesthesia on early postoperative cognitive function and hemodynamics in elderly patients with hip fractures

Abstract

Objective To investigate the influence of epidural block and general anesthesia on early postoperative cognitive function and hemodynamics in elderly patients with hip fractures. Methods 96 elderly patients with hip fractures in our hospital from January 2014 to December 2016 were chosen as experimental subjects, and were divided into control group and research group. The control group underwent general anesthesia, while the research group underwent general anesthesia combined with epidural block. The recovery of anesthesia, cognitive function, and hemodynamic changes between two group were compared. Results The time of anesthesia of the research group was shorter than that of the control group [(115.82±9.45)min vs.(120.27±10.08)min], with statistically different difference (P 0.05). The extubation time, eye opening time, and response time of the research group were all shorter than those of the control group [(13.41±3.08)min vs.(19.83±2.81)min, (12.26±3.43)min vs.(17.35±2.76)min, (15.17±4.39)min vs.(20.72±4.11)min], with statistically different differences (P 0.05). SBP of the two groups all decreased greatly, but without statistically different difference between the two groups (P>0.05). MMSE score of the research group 12 h after operation [(24.73±1.09) points vs.(21.24±1.6) points], 1 d after operation [(26.45±0.84) points vs.(23.71±0.92) points], 7 d after operation [(28.52±1.23) points vs.(25.17±1.28) points], 28 d after operation [(28.12±1.14) points vs.(26.23±1.21) points] were higher than those of the control group, with statistically different differences (P<0.05). Conclusion Epidural block combined with general anesthesia could reduce the influence on early postoperative cognitive function in elderly patients with hip fractures, and has fewer influence on hemodynamics, with postoperative fast anesthesia recovery. Key words: Hip; Fractures; Elderly patients; General anesthesia; Epidural block; Cognitive function