Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (35): 6514-6517.doi: 10.3969/j.issn.1673-8225.2011.35.013

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Effects of epidural analgesia and intravenous analgesia on early postoperative cognitive dysfunction after limb orthopedics surgery in the elderly

Wang Shi-ying, Kong Ling, Bi Guang-yan, Wei Guang-wu   

  1. Department of Anesthesiology, Second Affiliated Hospital of Jianghan University, Wuhan  430070, Hubei Province, China
  • Received:2011-06-07 Revised:2011-07-02 Online:2011-08-27 Published:2011-08-27
  • About author:Wang Shi-ying, Attending physician, Department of Anesthesiology, Second Affiliated Hospital of Jianghan University, Wuhan 430070, Hubei Province, China lmh061127@163.com, wangshi88@qq.com

Abstract:

BACKGROUND: Postoperative cognitive dysfunction (POCD) is being recognized as a complication contributing to perioperative morbidity and mortality of the elderly. We hypothesized that the use of postoperative epidural analgesia would be associated with less incidence of POCD when compared with postoperative intravenous analgesia after limb orthopedics surgery in the elderly.
OBJECTIVE: To compare the effects of epidural analgesia and intravenous analgesia on early postoperative cognitive dysfunction after limb orthopedics surgery in the elderly.
METHODS: Sixty aged patients undergoing elective limb orthopedics surgery were randomly allocated to receive either epidural anesthesia with postoperative intravenous analgesia or epidural anesthesia with postoperative epidural analgesia.
RESULTS AND CONCLUSION: POCD occurred in 14/30 patients (47%) in the intravenous analgesia group and in 9/30 patients (30%) in the epidural analgesia group. There was a significant difference between the two groups (P < 0.01). Logistic regression analysis showed that short duration of education and total hip arthroplasty were independent risk factors for the occurrence of early POCD. The results indicated that POCD occurred in 38% of the elderly patients undergoing limb orthopedics surgery and the epidural analgesia group had less negative effect on early POCD. Short duration of education and operation of total hip arthroplasty were risk factors for early POCD.

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