Analysis of the impact of anesthesia methods on postoperative cognitive function in elderly patients
麻醉方式对老年患者术后认知功能的影响分析

摘要

目的 本研究旨在探讨不同麻醉方式对老年患者术后认知功能的影响。方法 选取2022年4月至2025年4月在本院行择期髋关节置换术的160例老年患者，随机分为全身麻醉组与椎管内麻醉组。分别于术后1天、术后3天、7天采用简易精神状态检查量表（MMSE）和蒙特利尔认知评估量表（MoCA）评估认知功能，记录PND发生率。结果 术后1天，椎管内麻醉组MMSE评分与MoCA评分显著高于全身麻醉组（P<0.05），术后7天差异缩小（P>0.05）。椎管内麻醉组术后7天内PND发生率显著低于全身麻醉组（P<0.05）。结论 表明椎管内麻醉在短期内对老年患者术后认知功能的保护作用优于全身麻醉，可能为优化老年患者麻醉策略提供依据。

Abstract

Objective This study aims to explore the effects of different anesthesia methods on perioperative neurocognitive disorders (PND) in elderly patients.
Methods 160 elderly patients who underwent elective hip replacement surgery in our hospital from April 2022 to April 2025 were randomly divided into a general anesthesia group and a spinal anesthesia group. Cognitive function was evaluated using the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) on postoperative day 1, 3, and 7, respectively, and the incidence of PND was recorded.
Results On postoperative day 1, the MMSE and MoCA scores in the spinal anesthesia group were significantly higher than those in the general anesthesia group (P<0.05), and the difference narrowed on postoperative day 7 (P>0.05). The incidence of PND within 7 days after surgery in the spinal anesthesia group was significantly lower than that in the general anesthesia group (P<0.05).
Conclusion   This indicates that spinal anesthesia has a better protective effect on postoperative cognitive function in elderly patients in the short term than general anesthesia, which may provide a basis for optimizing anesthesia strategies for elderly patients.