Xiaoyu Gao, Feng Liu, Gang Wang, Xin Suyalatu*
Department of Orthopedics, Ordos Central Hospital, Ordos017000, Inner Mongolia, China
Objective: To determine the influence of epidural anesthesia and general anesthesia on perioperative cognitive function and deep venous thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA).
Methods: A total of 108 patients undergoing TKA in our hospital from November 2017 to August 2019 were enrolled as research objects, of which 58 patients given epidural anesthesia were assigned to a research group (res group), while the rest 50 patients given general anesthesia were assigned to a control group (con group). The consumed operation time, intraoperative blood loss as well as vascular resuscitation time of the two groups was recorded, and the changes in hemodynamic indexes of the two groups before anesthesia (T0), at 30 min after anesthesia (T1), and after operation (T2) were evaluated. In addition, the occurrence of adverse reactions and DVT in the two groups after operation was compared, and the Mini-Mental State Examination (MMSE) was used to analyze the cognitive function of the two groups.
Results: There was no notable difference in consumed operation time between the two groups (P> 0.05), while others of the res group were significantly lower than those of the con group (all P< 0.05). At T0, there was no notable difference in mean arterial pressure (MAP) between the two groups (P> 0.05 ), while at T1 and T2, MAP of both groups increased greatly compared with T0, and the MAP of the con group was notably higher than that of the res group (P< 0.05). From T0 to T2, the heart rate (HR) of the res group showed no notable difference, while the HR of the con group at T1 and T2 was notably higher than that of the group at T0, and also notably higher than that of the res group at the same time (P< 0.05). Moreover, the incidences of adverse reactions and DVT in the res group were greatly lower than those in the con group (both P< 0.05). Before anesthesia, there was no notable difference between the two groups in MMSE score, while at 1 d and 3 d after operation, the MMSE score of the res group was greatly higher than that of the con group (P< 0.01).
Conclusion: Epidural anesthesia results in less intraoperative blood loss and consumes shorter vascular resuscitation time for patients than general anesthesia, and it is more conducive to the stability of hemodynamics. It can also effective ameliorate postoperative cognitive dysfunction, and reduce DVT, with a higher safety. Therefore, epidural anesthesia is an ideal anesthesia method for patients undergoing TKA.
Epidural anesthesia, general anesthesia, total knee arthroplasty, cognitive function, deep venous thrombosis.