Effects Of Different Anesthesia Methods On Early Cognitive Function Of Elderly Patients Undergoing Hip Joint Replacement

ObjectiveTo analyze the effects of different anesthetic methods on cognitive dysfunction in elderly patients after hip replacement,and to discuss the effects of different anesthetic methods on POCD,to provide the clinical basis for the selection of anesthesia methods in elderly patients undergoing hip joint catheterization,and to explore the feasible measures to prevent the occurrence of POCD.MethodsA retrospective analysis of 80 patients who underwent total hip arthroplasty at Jilin University between November 2020 and November 2020 was performed in the 2021,there were 40 cases in group E and 40 cases in group G.Baseline Information,intraoperative events,and postoperative complications were compared between the two groups,preoperative cognitive assessment was performed with mini-mental state examination（MMSE）at 1 day（t 1）,1 day（t 2）,3 days（t 3）,and 7 days（T 4）,respectively,the decrease of MMSE postoperative score more than 2 points is considered as the occurrence of cognitive dysfunction.Results1.There was no significant difference in general information between the two groups（P>0.05）,indicating that they were comparable.2.The incidence of POCD: 8 cases（17.5%）in group G and 2 cases（5%）in group E were significantly higher in group G than in group E（P<0.05）.However,the incidence of POCD in the two groups was not statistically significant 7d after surgery（P>0.05）.3.MMSE score: compared with the MMSE score one day before the operation,the difference in the MMSE score on the 7th day after the operation in group G was not statistically significant（P>0.05）,and the MMSE scores on the 1st and 3rd day after the operation were significantly reduced,with a statistical significance（P < 0.05）.There was no significant difference in MMSE scores of rats in group E at each time point（P>0.05）.4.Risk factors of POCD: A regression analysis was performed on the risk factors possibly related to POCD,and the results showed that operation duration,age and sleep duration were the risk factors for POCD after total hip arthroplasty（OR values were 6.525,1.372,and 0.736,respectively,P<0.05）.ConclusionCompared with general anesthesia,the incidence rate of cognitive dysfunction after total hip arthroplasty in elderly patients under combined spinal-epidural anesthesia is relatively low.Advanced age,long operation time and sleep disorder are the risk factors for POCD.