Effects of electroacupuncture assistant general anesthesia on postoperative cognitive dysfunction of aged patients
To observe the effects of electroacupuncture (EA) assistant general anesthesia on postoperative cognitive dysfunction (POCD) of aged patients.
One hundred and twenty senile American Society of Anesthesiology (ASA) grade I - III patients (more than 65 years old) with non-cardiac surgery were randomly assigned to two groups, Group A and Group B, 60 cases in each group. Patients in Group A received general anesthesia, while those in Group B received EA assistant general anesthesia. Patients in Group B received EA at Baihui (DU20), Hegu (LI4), Neiguan (PC6), Zusanli (ST36) 30 min before anesthesia induction to the end of operation. Anesthesia was induced by etomidate 0.2 - 0.3 mg/kg, fentanyl 3-5 microg/kg, cisatracurium 0.15 mg/kg in the two groups. Anesthesia maintenance was provided by sevoflurane and continuous pumping of remifentanil. Tramadol 50 mg was given 30 min before ending the operation. The scores of mini-mental state examination (MMSE), nausea and vomiting were recorded in the two groups one day before anesthesia, the 2nd, 4th, and 6th day after operation. The occurrence of postoperative cognitive dysfunction (POCD) on day 2, 4, and 6 was compared.
The occurrence of POCD on day 2 and 4 was obviously lower in Group B than in Group A at the same time period (40.0% vs 66.7%, 13.3% vs 43.3%), showing statistical difference (P < 0.05). There was no significant difference in the pre-anesthesia scores of MMSE between the two groups. The scores of MMSE on the 2nd and the 4th day were higher in Group B than in Group A (21.3 +/- 3.9 vs 18.3 +/- 3.8, 26.4 +/- 2.9 vs 22.9 +/- 3.9, P < 0.05). Compared with one day before anesthesia in the same group, the scores of MMSE were significantly different on the 2nd and the 4th day (Group A: 18.3 +/- 3.8, 22.9 +/- 3.9 vs 27.9 +/- 2.1; Group B: 21.3 +/- 3.9 vs 27.5 +/- 2.5; P < 0.05). The occurrence of post-aesthesia nausea and vomiting was lower in Group B (23.3%, 14/60) than in Group A (46.7%, 28/60) with statistical difference (P < 0.05).
EA assistant general anesthesia could reduce the occurrence of POCD in aged patients.