Effects of different anesthesia methods on postoperative cognitive function and high mobility group protein B1 for patients undergoing gastrointestinal surgery

  Objective  To investigate the effects of different anesthesia methods on postoperative cognitive function and high mobility group protein B1 (HMGB-1) in peripheral blood of patients undergoing gastrointestinal surgeries.

  Methods  A total of 60 elderly patients who underwent laparoscopic gastrointestinal surgeries were selected as the study objects. According to the different anesthesia methods used in the operation, they were randomly divided into two groups, with 30 cases in the combined group and 30 cases in the control group. General anesthesia combined with epidural anesthesia was used in the combined group, while general anesthesia was used in the control group. The perioperative indexes, level of serum HMGB-1 and Mini-mental State Examination(MMSE) scores at different time points, incidence of postoperative cognitive dysfunction (POCD) were compared between the two groups.

  Results  The extubation time and recovery time of the combined group were significantly shorter than those of the control group (P < 0.05), while there were no significant differences in operation time and bleeding volume between the two groups (P>0.05). At T₁, there were no significant differences between the two groups in serum HMGB-1 level and MMSE score (P>0.05); while the level of serum HMGB-1 at T₂ in the combined group was significantly higher than that at T₁, and MMSE score was significantly lower than that at T₁ (P < 0.05). There were no significant differences in HMGB-1 level and MMSE score between T₃ and T₁ in the combined group(P>0.05). The levels of serum HMGB-1 at T₂ and T₃ in the control group were significantly higher than those at T₁, and the MMSE score was significantly lower than that at T₁ (P < 0.05). The levels of serum HMGB-1 in the combined group at T₂ and T₃ were significantly lower than those in the control group, and the MMSE scores were significantly higher than those in the control group (P < 0.05). The incidence rates of POCD in the combined group at T₂ and T₃ were significantly lower than those in the control group (P < 0.05).

  Conclusion  General anesthesia combined with epidural anesthesia for elderly patients undergoing gastrointestinal surgeries can correct the level of HMGB-1 in peripheral blood as soon as possible and reduce the incidence of POCD after surgeries.