关键词: 气管插管全身麻醉, 腰硬联合麻醉, 泌尿外科手术, 认知功能

Abstract: Objective To compare the effects of different anesthesia methods on cognitive function in elderly patients undergoing urologic surgery by using combined epidural anesthesia and tracheal intubation general anesthesia. Methods Sixty-five elderly urological patients who underwent titanium laser lithotripsis for ureteral calculi admitted to our hospital from January 2022 to December 2022 were selected as the study objects, and were divided into general anesthesia group (32 cases) and combined anesthesia group (33 cases) according to randomization rule, and received tracheal intubation general anesthesia and combined epidural anesthesia, respectively. Anesthesia-related indicators, VAS pain score, brief Mental State Examination Scale (MMSE), and incidence of cognitive dysfunction were evaluated between the two groups. Results The rate of excellent and good anesthesia in combination group was 87.88% higher than that in general anesthesia group (59.38%) (P<0.05). Compared with the preoperative results, the VAS score of the general anesthesia group and the combined group was lower (P<0.05), and the VAS score of the combined group was lower than that of the general anesthesia group (P<0.05). Compared with the preoperative results, the MMSE scores in both the general anesthesia group and the combined group were lower after operation (P<0.05), and the MMSE scores in the combined group were higher than those in the general anesthesia group (P<0.05). The incidence of cognitive dysfunction 6 h and 24 h in the combined group was lower than that in the general anesthesia group (P<0.05). Conclusion Compared with tracheal intubation general anesthesia, lumbo-epidural anesthesia has better anesthetic effect, less influence on cognitive function, lower rate of cognitive dysfunction, and can promote postoperative recovery of patients.

Key words: tracheal intubation general anesthesia, combined spinal epidural anesthesia, urology surgery, cognitive function