Effect of combined spinal and epidural anesthesia on pain and cognitive function in elderly patients with lower limb fracture / 中国基层医药

ABSTRACT

Objective:To analyze the effect of combined spinal-epidural anesthesia on the degree of pain and cognitive function in elderly patients with fracture of lower extremity.Methods:From January 2016 to January 2018, 82 elderly patients with lower extremity fracture treated in Dajiangdong Hospital of Hangzhou were randomly divided into control group and observation group according to the random digital table method.The patients in the control group were treated with general anesthesia, and the patients in the observation group were treated with combined spinal and epidural anesthesia.The anesthesia effects of the two groups were analyzed.Results:The onset time of anesthesia and sensory block, and duration of sensory block in the observation group were (5.69±2.00)min, (32.65±2.59)min and (98.21±10.14)min, respectively, which were shorter than those in the control group ( t=5.646, 19.576, 22.613, all P<0.05). Before operation, there were no statistically significant differences in VAS score and MMSE score between the two groups ( t=0.093, 0.056, all P>0.05). On the 1st day, 3rd day and 7th day after operation, the VAS scores in the observation group were lower than those in the control group ( t=2.118, 1.718, 5.372, all P<0.05). The scores of MMSE in the observation group were significantly higher than those in the control group ( t=6.175, 4.628, 3.078, all P<0.05). The VAS score in the observation group was lower than that in the control group on the 14th day after operation ( t=5.582, P<0.05), and there was no statistically significant difference in MMSE score between the two groups ( t=0.023, P>0.05). The incidences of adverse reaction and postoperative cognitive dysfunction in the observation group were 4.88% and 12.20%, respectively, which were significantly lower than those in the control group (29.27% and 31.71%) (χ 2=8.613, 4.556, all P<0.05). Conclusion:Combined spinal-epidural anesthesia can relieve postoperative pain, promote the recovery of cognitive function, and reduce the incidence of adverse reactions and postoperative cognitive dysfunction in elderly patients with lower limb fracture.