Effect of the general anesthesia and epidural anesthesia on the postoperative cognitive function and stress response in elderly patients

Objective:To investigate the effects of general anesthesia and epidural anesthesia on the postoperative cognitive function and the stress response in elderly patients.Methods:Seventy-two elderly patients treated with surgery were divided into the observation group and control group according to random number table method(36 cases each group).The observation group and control group were anesthetized using the epidural and general anesthesia,respectively.The cognitive function in two groups before and after operation was assessed using easy mental state examination table(MMES) and Wechsler memory scale(WMS).The levels of glucose(Glu) and high-sensitivity C-reactive protein(hs-CRP) in two groups at preoperative and postoperative 30 min and postoperative 6 h,and stress reaction of patient were analyzed.Results:The differences of the incidence rate of the cognitive disorder between two groups after 6h,24h and 72h of operation were not statistically significant(P>0.05).The scores of MMES and WMS in observation group after operation were higher than those before operation(P<0.05 to P<0.01),and the differences of which between before operation and after 3 d of operation was not statistically significant(P>0.05).The scores of MMES and WMS(except Memory pictures and Memory touch items) in control group after 1 d of operation were significantly higher than those before operation(P<0.01).The scores of MMES and Memory experience of WMS in observation group after 1 d of operation were significantly lower than those in control group(P<0.01),and the score of memory pictures of WMS in observation group after 1 d of operation was higher than that in control group(P<0.01).The scores of WMS(except Memory orientation and Memory touch items) in observation group after 3d of operation were significantly lower than those in control group(P<0.01).The levels of Glu and hs-CRP in observation group after 0.5h and 6 h of operation were significantly lower than those in control group(P<0.01).Conclusions:Compared with general anesthesia,the effect of epidural anesthesia on cognitive function and stress reaction is little,the dose of drug is little.The epidural anesthesia is especially appropriate for elderly patients,and worthy of clinical promotion.