ABSTRACT
Objective To investigate the effects of two anesthetic modes on cognitive function in elderly patients undergoing laparoscopic cervical cancer resection .Methods From August 2016 to April 2018,60 elderly patients undergoing laparoscopic cervical cancer resection in the General Hospital of Armed Police were divided into control groupand observation group according to odd and even of bed number ,with 30caese in each group.Intravenous anesthesia was used in the control group ,and intravenous anesthesia combined with inhalation anesthesia was used in the observation group.The anesthetic effect,MMSE score,MoCA score and the incidence of cognitive dysfunction were compared between the two groups.Results The anesthesia effect time,extubation time and recovery time of the observation group were (1.62 ±0.30) min,(15.68 ±3.26) min,(8.69 ±3.68) min,respectively,which were significantly shorter than those of the control group [(4.68 ±0.91)min,(27.46 ±4.03)min,(20.36 ±4.58)min] (all P<0.05).There were no statistically significant differences in MMSE score and MoCA score between the two groups before operation (all P<0.05),and there was statistically significant difference in MMSE score between the two groups at 2 h and 6 h after operation (all P<0.05).The MMSE score in the observation group was higher than that in the control group(all P<0.05),but there was no statistically significant difference on the 1st day after operation (P>0.05).At 2 h,6 h,1 d after operation,the MoCA scores in the observation group were significantly higher than those in the control group (all P<0.05).The incidence of cognitive dysfunction in the observation group was 6.67％(2/30), which was significantly lower than 26.67％( 8/30 ) in the control group ( P <0.05 ).Conclusion Compared with intravenous anesthesia alone , intravenous anesthesia combined with inhalation anesthesia for elderly patients undergoing laparoscopic cervical cancer resection has a good anesthetic effect and can reduce the incidence of cognitive dysfunction ,which is worthy of further application in clinical practice .
ABSTRACT
Objective:To evaluate the efficacy of erector spinae plane block (ESPB) for transforaminal endoscopic surgery.Methods:Sixty patients of both sexed, aged 20-45 yr, with body mass index of 17.5-29.0 kg/m 2, of American Society of Anesthesiologists physical status ⅠorⅡ, undergoing percutaneous transforaminal endoscopic lumbar discectomy, were divided into 2 groups ( n=30 each) by using a random number table method: ESPB group (E group) and local infiltration anesthesia group (L group). Group E received the ultrasound-guided ESPB, group L received layer-by-layer-assisted local infiltration anesthesia (including subcutaneous layer and fascia, muscular layer and superior articular process) according to the location of operation, and 0.5% ropivacaine 20 ml was used as local anesthetic in both groups.Operation time and C-arm X-ray localization time were recorded.Visual analogue scale score and Ramsay sedation score were recorded at skin incision (T 1), muscle separation (T 2), foraminoplasty (T 3), nerve root decompression (T 4) and skin suture (T 5). The effective analgesia and satisfaction with sedation were recorded.Patients were followed up postoperatively for patient satisfaction, lower extremity motor block, development of nausea and vomiting, dizziness, hematoma at puncture site, nerve damage and etc.Functional status was assessed using the Oswestry Disability Index. Results:Compared with group L, visual analogue scale scores were significantly decreased at T 2-4, Ramsay sedation scores were increased at T 3, 4, patient′s satisfaction was increased, operation time and C-arm X-ray localization time were shortened ( P<0.05), and no significant change was found in Oswestry Disability Index score or rate of satisfactory analgesia in group E ( P>0.05). No motor block, nausea and vomiting, dizziness, hematoma at puncture site and nerve damage was found in both groups. Conclusion:ESPB can provide satisfactory analgesia with a higher safety when used for trasforaminal endoscopic surgery.
ABSTRACT
Objective@#To investigate the effects of two anesthetic modes on cognitive function in elderly patients undergoing laparoscopic cervical cancer resection.@*Methods@#From August 2016 to April 2018, 60 elderly patients undergoing laparoscopic cervical cancer resection in the General Hospital of Armed Police were divided into control groupand observation group according to odd and even of bed number, with 30caese in each group.Intravenous anesthesia was used in the control group, and intravenous anesthesia combined with inhalation anesthesia was used in the observation group.The anesthetic effect, MMSE score, MoCA score and the incidence of cognitive dysfunction were compared between the two groups.@*Results@#The anesthesia effect time, extubation time and recovery time of the observation group were (1.62±0.30)min, (15.68±3.26)min, (8.69±3.68)min, respectively, which were significantly shorter than those of the control group[(4.68±0.91)min, (27.46±4.03)min, (20.36±4.58)min](all P<0.05). There were no statistically significant differences in MMSE score and MoCA score between the two groups before operation (all P<0.05), and there was statistically significant difference in MMSE score between the two groups at 2 h and 6 h after operation (all P<0.05). The MMSE score in the observation group was higher than that in the control group(all P<0.05), but there was no statistically significant difference on the 1st day after operation (P>0.05). At 2 h, 6 h, 1 d after operation, the MoCA scores in the observation group were significantly higher than those in the control group (all P<0.05). The incidence of cognitive dysfunction in the observation group was 6.67%(2/30), which was significantly lower than 26.67%(8/30) in the control group (P<0.05).@*Conclusion@#Compared with intravenous anesthesia alone, intravenous anesthesia combined with inhalation anesthesia for elderly patients undergoing laparoscopic cervical cancer resection has a good anesthetic effect and can reduce the incidence of cognitive dysfunction, which is worthy of further application in clinical practice.