Effects of different postoperative analgesic strategies on postoperative neurocognitive function and quality of recovery in elderly patients undergoing one lung ventilation.
10.12122/j.issn.1673-4254.2020.12.19
- Author:
Wei WEI
1
;
Xi ZHENG
1
;
Yu GU
1
;
Chunlin TANG
1
;
Yonghua YAO
1
Author Information
1. Department of Anesthesiology, Cancer Center of Guangzhou Medical University, Guangzhou 510000, China.
- Publication Type:Randomized Controlled Trial
- Keywords:
continuous thoracic paravertebral block;
postoperative analgesia;
postoperative neurocognitive dysfunction;
quality of recovery
- MeSH:
Aged;
Analgesia, Epidural;
Analgesics;
Humans;
Nerve Block;
One-Lung Ventilation;
Pain, Postoperative
- From:
Journal of Southern Medical University
2020;40(12):1821-1825
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the effects of different postoperative analgesic strategies on neurocognitive function and quality of recovery in elderly patients at 7 days after thoracic surgery with one lung ventilation.
METHODS:Ninety elderly patients undergoing video-assisted thoracic surgery were randomized into 3 groups (
RESULTS:The patients in TA and EA groups had significantly higher MMSE scores and lower incidence of postoperative neurocognitive dysfunction (PNCD) than those in GA group without significant difference between the former two groups. At 7 days after the surgery, serum levels of S100-β and MMP-9 were significantly higher in GA group than in TA and EA group, and did not differ significantly between the latter two groups. QoR-40 scores were significantly higher in TA and EA groups than in GA group, and were higher in TA group than in EA group. The chest intubation time and length of hospital stay were significantly shorter in TA and EA groups than in GA group.
CONCLUSIONS:In elderly patients undergoing surgeries with one lung ventilation, general anesthesia combined with either postoperative continuous thoracic paravertebral block or epidural analgesia can significantly improve postoperative neurocognitive function and quality of recovery, but continuous thoracic paravertebral block analgesia can be more advantageous for improving postoperative quality of recovery.
