The Effect Of Combined General And Epidural Anesthesia For Abdominal Surgery On The Incidence Of Post Operative Congnitive Dysfunction In Elderly.

Objective:To observe if combined general and epidural anesthesia for abdominal surgery had the effect that decreasing the incidence of post operative congnitive dysfunction POCD.Methods:Thirty ASAⅠtoⅢelderly patients with the familiar state before the scheduled abdominal operation were allocated into two groups randomly.Both of the group A(Combined general and epidural anesthesia group,n=15)and group B(general anesthesia,n=15)had the same drug for induction and maintenance.Epidural block were performed and attached to the operation satisfactory plane before induction in Group A,and PCEA was used after operation.BP,HR,SPO2 were measured and bleeding amount,dosage,time for anesthesia,operation,awareness were recorded either.Mini-mental state examination(MMSE)test were given to the patients before the operation and repeated 7 days after it. Steward and VAS test were also used.Blood samples were taken in different times to determine S100ββprotein levels.Results:There were no significant changes in the aspects of age, weight,ASA degree,SDS scores,time for operation,bleeding amout and etc.(P＞0.05)BP,HR increased significantly after trachea intubation and extubation in group B when there were so stabilization in group A. Time for awake was shorter in group A compared with group B(P＜0.01). Meanwhile,Steward and VAS scores showed a good awareness and analgesia post operation in group A.The scores of MMSE in group B decrease manifest after operation and showed three cases had happened POCD with the manisfest increasing of S100ββprotein.There were little change in group A,and with the time gone,S100ββrecovered to the preoperation levels in group B.Conclusions:Combined general and epidural anesthesia can reduce the incidence of POCD for the abdominal surgery in elderly.