Effect of alcoholism history on early post-operative cognitive function in elderly patients after general an-esthesia / 临床麻醉学杂志

Objective To evaluate the effect of alcoholism history on the elderly patients’early cognitive function after lower abdominal or limbs surgery under general anesthesia through controlled clinical trials.Methods Sixty male patients aged 65-80 years of ASA grade Ⅰ or Ⅱ were selected un-dergoing lower abdominal or limbs surgery,30 cases with alcoholism history as alcohol group(group A),30 cases without alcoholism experience as control group (group C).All patients were anesthe-tized intravenously.The general data before and during operation,and the postoperative complications were recorded.The mini mental state examination(MMSE)was performed to assess the cognitive function 1d before and 1,7 d after surgery,then post-operative cognitive dysfunction(POCD)was compared between the two groups through analysis of the MMSE score.Results The MMSE score of 1,7 d after surgery in two groups was significantly lower than that of the preoperative(P < 0.05 ). Compared with the score 1 d after surgery,the score of 7 d post-operation was significantly higher in group A (P <0.05).The postoperative score in group A were significantly lower than that in group C 1,7 d after surgery (P <0.05).The incidence of POCD in group A were higher than that in group C 1,7 d after surgery (P <0.05 ).Conclusion Alcoholism history can increase the incidence of early cognitive dysfunction in elderly patients after general anesthesia.

Should the lower end of the spinal cord be localized by MRI in all patients having low backache prior to spinal anesthesia?

This study investigates the position of the lower end of the spinal cord conus in Chinese adults with low backache using MRI, to locate the safe puncture site for spinal anesthesia. Eight hundreds adults suffering from low backache were included in the study. Magnetic resonance imaging was used to localize the lower end of the spinal cord conus. Adult females' conus positions were slightly lower than the males [median: L1:lower, quartile: L1:middle-L1:upper for females; median: L1:lower, quartile: L1:upper-L2 for males; P < 0.001]. In addition our data showed that in 23.25% of patients the tip of the conus was located at the upper 1/3 level of L3. Pearson's correlation analysis showed that when the study population was divided by age group [Group A = 30 years of age; Group B = 30-60 years old; Group C = more than 60 years of age], cone position was significantly lower in older patients [r= 0.113, P < 0.05]. Spinal puncture should not be performed higher than the L3-L4 intervertebral space in Chinese patients having low backache unless the position of the lower end of the spinal cord is identified by prior MRI