Key result
Combined spinal and epidural anesthesia resulted in a similar incidence of early cognition impairment compared to general anesthesia in elderly patients undergoing non-cardiac surgery (48.5% vs 44.7%).
Why the study?
Does combined spinal and epidural anesthesia and epidural analgesia reduce early cognition impairment compared to general anesthesia in elderly patients undergoing non-cardiac surgery?
RCT (n=206)
Randomly divided
Does combined spinal and epidural anesthesia and epidural analgesia reduce early cognition impairment compared to general anesthesia in elderly patients undergoing non-cardiac surgery?
Different anesthetic and analgesic methods (regional vs general) do not significantly influence the incidence of early postoperative cognitive impairment in elderly patients undergoing non-cardiac surgery.
Answers are grounded in this paper and cite their sources.
No difference in early cognitive impairment with combined spinal-epidural versus general anesthesia; confirms anesthetic technique does not influence this outcome in elderly non-cardiac surgery.
OBJECTIVE: To discuss over influence of two different anesthetic and analgesic methods on early cognitive function of elderly patients who received non-cardiac surgery. METHODS: Two hundred and six elderly patients who underwent non-cardiac surgery were selected as research subjects. They were randomly divided into observation group (103 cases) and control group (103 cases). Patients in observation group were given combined spinal and epidural anesthesia and epidural analgesia, while patients in control group adopted general anesthesia and intravenous analgesia. Neurological function test was carried out one day before surgery and on the 7(th) day after surgery. Moreover, changes of postoperative pain degree, neuropsychological function and cognitive function were observed and compared. RESULTS: On the 7(th) day after surgery, incidence of cognition impairment in observation group and control group was 48.50% (50/103 cases) and 44.70% (46/103 cases), and difference between groups had no statistical significance. Visual Analogue Scale (VAS) Score of observation group was much lower than control group in the 12(th), 24(th) and 48(th) h after surgery (p < 0.05). Logistic regression analysis suggested that, short education years and general surgery were independent risk factors for early cognition impairment. CONCLUSION: About 46.60% elderly patients undergoing non-cardiac surgery developed cognition impairment, but influence of different anesthetic and analgesic methods on incidence of postoperative cognition impairment of elderly patients had no significant difference.
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Wang et al. (2016) conducted an RCT in Non-cardiac surgery (n=206). Combined spinal and epidural anesthesia and epidural analgesia vs. General anesthesia and intravenous analgesia was evaluated on Incidence of cognition impairment on the 7th day after surgery. Combined spinal and epidural anesthesia resulted in a similar incidence of early cognition impairment compared to general anesthesia in elderly patients undergoing non-cardiac surgery (48.5% vs 44.7%).
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