Effects of different anesthesia methods on postoperative cognitive function in elderly patients with lung cancer

doi:10.3969/j.issn.1674-3806.2015.04.12

Abstract：Objective To compare the influence of epidural anesthesia and general anesthesia on the postop -erative cognitive function in elderly patients with lung cancer .Methods Ninety-three lung cancer patients who were older than 60 years, planned for selective radical resection of pulmonary carcinoma , were assigned to receive either epidural anesthesia(observed group, n=46) or general anesthesia(control group, n=47).Mini-mental state exami-nation(MMSE) was performed respectively at the time of preoperative 1 day, postoperative 6 hour, 1 day, 3 day and 7 day to assess the patients′cognitive function .Blood samples were collected at the moment of preoperative 10 min, postoperative 30 min, 1 day and 3 day for the detection of serum concentration of S 100-βprotein.Results Signifi-cant difference in postoperative MMSE score was associated with the methods of anesthesia and postoperative time , and there was interaction between the methods of anesthesia and postoperative time .MMSE score at the moment of post-6 h was lower than that at the time of pre-1 d in each group ( observed group: P=0.000; control group: P=0.000, respectively), at the time of post-6 h and 1 d, the MMSE score in the control group was lower than that in the observed group(P=0.003, P=0.007, respectively).The incidence of postoperative cognitive dysfunction (POCD) at the time of post-6 h in the observed group was lower than that in the control group ( 13.0% vs 31.9%, P=0.030 ) .Significant difference in serum S 100-βprotein level was associated with postoperative time , the serum S100-βprotein level at the time of post-30 min was higher than that at the time of pre-10 min in each of group ( observed group:P=0.010;control group:P=0.000 , respectively );but no significant difference of S 100-βprotein level was found between the two groups at post-30 min, 1 d and 3 d.Conclusion Epidural anesthesia exerts limited influence on cognitive function and lower incidence of POCD for elderly patients with lung cancer , compared to general anesthesia .