The Effect Of Alcoholic History On Early Post-operative Cognitive Dysfunction In Elderly Patients After General Anesthesia

Objective: The study intends to evaluate the history of alcoholism on the elderlypatients’ early cognitive dysfunction after non-cardiac and non-nervous systemanesthesia through controlled clinical trials, and to provide more reference for clinicians.Methods: Selected30aged65and older male patients who had a alcoholic historyand scheduled for elctive lower abdominal or limbs surgery from June2013to July2014,as the alcoholism group(D group), the standard of alcoholism was the average dailyalcohol intake reached60g and lasting for5years and longer, whether current drinking ornot, and selected30disease and surgical site matched cases as control group (group C).The preoperative preparation in two groups was same, the routine monitoring was carriedout after each patient arriving in operating room, then implemented the order inductionand completed the total infusion venus anesthesia through propofol plus remifentanicontinuous infusion. Recorded preoperative general data, alcohol drinking pattern, mainanesthesia data, and the postoperative complications.The mini mental state examinationwas performed to assess the cognitive function1day before and1day,7days aftersurgery, the scale included ability of orientation, memory, attention and computing,recalling, language and visual in spacel. Respectively recorded the score of each item andtotal, then compared post-operative cognitive dysfunction happened before and afteroperation, as well as between the two groups through analysis of the MMSE score.Results: There’s no clear difference on the general situation and dosage of propofol,fentanyl and remifentanil between the two groups. The MMSE score of first andsenventh day after surgery in two groups were significantly lower than the preoperative,and the former reduced more obviously; The score in twice postoperation of alcoholgroup were significantly lower than control group(P＜0.05); The incidence of POCD at the first day after surgery is40%which was higher than16.7%in control group, and the36.7%rate valued at the seventh day after surgery was higher than13.3%in controlgroup(P＜0.05); The memory ability decreased most apparently in alcohol group amongthe six items of POCD assessment. Although the complication incident of respiratorysystem, circulatory system, infection, transferred to the ICU, visual analogue scalereached7in alcohol group is slightly higher than the control group, there was nosignificant difference after atatistical analysis(P>0.05).Conclusion: Alcoholism history can increase the incidence of early cognitivedysfunction in elderly patients after general anesthesia, and the memory damage is themost obvious; The damand of anesthetic in older adults don’t increase.