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Effect of different anesthesia and analgesic methods on recovery of gastrointestinal function in elderly patients after open surgery

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Author:
No author available
Journal Title:
World Chinese Journal of Digestology
Issue:
19
DOI:
10.11569/wcjd.v26.i19.1199
Key Word:
腰硬联合麻醉;硬膜外镇痛;开腹手术;胃肠功能;并发症;术后认知功能障碍;Combined spinal and epidural anesthesia;Epidural analgesia;Open surgery;Gastrointestinal function;Complications;Postoperative cognitive dysfunction

Abstract´╝Ü AIM To explore the effect of different anesthesia and analgesia methods on gastrointestinal function recovery in elderly patients after open surgery.METHODS A total of 100 elderly patients undergoing open surgery from April 2016 to December 2017 were selected and divided into a control group (n = 50) and an observation group (n = 50) according to the method of anesthesia and analgesia. In the control group, systemic intravenous anesthesia and meridian analgesia were used. In the observation group, combined spinal and epidural anesthesia and epidural analgesia were used. Time to first defecation, time to recovery of gastrointestinal peristalsis, and time to food intake were recorded. Immunoradiometric method was used to determine plasma motilin levels before and after anesthesia and analgesia. The visual analog scale (VAS) was used to evaluate the pain degree of the two groups before anesthesia and analgesia and 6 h, 12 h, 18 h and 24 h after anesthesia and analgesia. The incidence of complications such as nausea and vomiting, elevated blood pressure, abnormal liver and kidney function, and post-cognitive dysfunction (POCD) were also recorded.RESULTS Time to first defecation, time to recovery of gastrointestinal peristalsis, and time to food intake in the observation group were significantly shorter than those in the control group (P< 0.05). Plasma motilin levels in the observation group after anesthesia and analgesia were significantly higher in the observation group thanin the control group (P< 0.05). VAS scores at 6 h, 12 h, and 18 h after anesthesia and analgesia were significantly lower than those before anesthesia and analgesia in both groups, and were significantly lower in the observation group than in the control group (P< 0.05). The incidence of nausea and vomiting, diarrhea, elevated blood pressure, abnormal liver and kidney function, and POCD was significantly lower in the observation group than in the control group (P< 0.05).CONCLUSION The combination of lumbar-sparing anesthesia and epidural analgesia in elderly patients undergoing laparotomy can promote the early recovery of gastrointestinal function and reduce pain, and has a low incidence of postoperative complications.

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