Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (26): 4139-4143.doi: 10.3969/j.issn.2095-4344.2015.26.008

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Different analgesia in elderly patients with total knee arthroplasty: incidence of cognitive dysfunction

Wu Jun   

  1. Liuzhou City People’s Hospital Affiliated to Guangxi University of Science and Technology, Liuzhou 545006, Guangxi Zhuang Autonomous Region, China
  • Received:2015-05-08 Online:2015-06-25 Published:2015-06-25
  • About author:Wu Jun, Attending physician, Liuzhou City People’s Hospital Affiliated to Guangxi University of Science and Technology, Liuzhou 545006, Guangxi Zhuang Autonomous Region, China

Abstract:

BACKGROUND: Elderly patients may suffer from cognitive dysfunction after arthroplasty, which easily leads to the emergence of various postoperative complications, and even leads to the death of the patient. Different methods of analgesia are used to reduce the incidence of cognitive dysfunction after lower limb arthroplasty in elderly patients.
OBJECTIVE: To compare the incidence of early cognitive dysfunction in elderly patients with total knee arthroplasty under different analgesia.
METHODS: A total of 82 elderly patients with total knee arthroplasty in the Liuzhou City People’s Hospital Affiliated to Guangxi University of Science and Technology from December 2013 to December 2014 were enrolled in this study, equally and randomly assigned to control group and observation group, which received general anesthesia and epidural anesthesia, respectively. At 3 days after arthroplasty, Mini Mental State Examination score, visual analogue scale score and incidence rate of postoperative cognitive dysfunction in the two groups were observed and compared.
RESULTS AND CONCLUSION: No significant difference in Mini Mental State Examination score was detected between the two groups (P > 0.05), but visual analogue scale score and incidence rate of postoperative cognitive dysfunction were significantly lower in the observation group than in the control group (P < 0.05). Moreover, visual  analogue scale score was an independent risk factor for postoperative cognitive dysfunction (P < 0.05). These findings suggest that regarding the effect in the early postoperative cognitive function, implementation of intravenous anesthesia or epidural anesthesia in elderly patients undergoing total knee arthroplasty does not have apparent difference. As for the incidence of postoperative analgesic effect and postoperative cognitive dysfunction, epidural analgesia is better. Through analysis, the pain is a risk factor for cognitive dysfunction after total knee arthroplasty in elderly patients.

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Arthroplasty, Replacement, Knee, Analgesia, Anesthesia, Intravenous, Anesthesia, Epidural, Cognition Disorders

CLC Number: