关键词: 膝关节置换术, 老年, 全麻, 硬膜外麻醉, 血流动力学, 认知功能

Abstract: Objective To observe the effect of general anesthesia combined with epidural anesthesia on cognitive function of elderly patients with knee arthroplasty. Methods Eighty patients who received knee arthroplasty from February 2015 to March 2019 were selected, and according to the random number table method they were divided into an observation group and a control group, with 40 cases in each group. The control group received continuous epidural anesthesia, and the observation group received general anesthesia combined with epidural anesthesia. The hemodynamic changes at different time points during operation were compared between the two groups. The Mini Mental State Examination （MMSE） scale was used to assess the occurrence of cognitive dysfunction in the patients. Results Before entering the operation room, there was no significant difference in hemodynamic indicators between the two groups （P>0.05）; during skin incision and after bone cement filling, the hemodynamic indicators of patients in both groups were decreased gradually compared with those before, but the reduction in the observation group was smaller than that in the control group, namely the hemodynamic indicators in the observation group were higher than those in the control group （P<0.05）. At 3 days after operation, no difference was found in the incidence rate of cognitive dysfunction between the two groups （P>0.05）; but the degree of cognitive dysfunction in the observation group was slighter than that in the control group （P<0.05）. Conclusion General anesthesia combined with epidural anesthesia has a definite effect for elderly patients with knee arthroplasty, which has little influence on hemodynamics and postoperative cognitive function, and is safe and reliable.

Key words: Knee arthroplasty, Elderly, General anesthesia, Epidural anesthesia, Hemodynamics, Cognitive function