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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 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.
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Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.ResultsTwo groups at T0, T1 esophageal temperature no significant difference, study group t2-t6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference (P<0.05), and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).ConclusionThe surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.
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Objective To study the effect of preemptive analgesia with tramadol on ovarian cancer patients with stress reaction.Methods 80 cases with ovarian cancer undergoing elective surgery under general anesthesia were divided into the observation group and the control group according to the computer randomly generated control table,40 cases in each group.Patients in the observation group with PECA were pumped into tramadol after anesthesia induction,while the control group was in the same conditions of pumping tramadol after operation.Patients were all treated with intravenous patient -controlled analgesia with sufentanil after waking up.The blood concentrations of cortisol (COR),adrenal cortical hormone (ACTH),angiotensin Ⅱ (AT Ⅱ)were determined by radioimmunoassay, and the blood concentrations C reactive protein (CRP)was determined by immune turbidity method.The adverse reactions and the VAS score of patients after 2h,6h,12h,24h,48h were recorded.Results The COR,ACTH,AT Ⅱ, CRP concentrations of the two groups had no significant differences (all P >0.05)before operation.After each time point,COR[(208.5 ±31.6)ng/mL vs (446.3 ±19.8)ng/mL],ACTH[(35.7 ±8.2)pg/mL vs (63.5 ±9.1)pg/mL],AT Ⅱ[(46.8 ±10.9)pg/mL vs (75.9 ±12.5)pg/mL],CRP[(3.9 ±0.7)mg/mL vs (40.5 ±2.9)mg/mL] concentrations were significantly higher than those of pre -operation (all P 0.05);At the time of coughing,the two groups were significantly differ-ent only at the 6h[(2.5 ±0.6)vs (3.1 ±0.8)]and 12h[(2.1 ±0.6)vs (2.9 ±0.4)]time point (t =13.406, P =0.012;t =12.625,P =0.025).Conclusion Preemptive analgesia with tramadol and sufentanil for postoperative analgesia can effectively reduce the radical resection of postoperative pain and the stress reaction after surgery.It is a safe and effective analgesic method.