Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Alzheimers Dement. 2019 Oct;15(10):1243-1252. doi: 10.1016/j.jalz.2019.06.4949. Epub 2019 Sep 5.
Our aim was to examine whether surgery with regional anesthesia (RA) is associated with accelerated long-term cognitive decline comparable with that previously reported after general anesthesia (GA).
Longitudinal cognitive function was analyzed in a cohort of 1819 older adults. Models assessed the rate of change in global and domain-specific cognition over time in participants exposed to RA or GA.
When compared with those unexposed to anesthesia, the postoperative rate of change of the cognitive global z-score was greater in those exposed to both RA (difference in annual decline of -0.041, P = .011) and GA (-0.061, P < .001); these rates did not differ. In analysis of the domain-specific scores, an accelerated decline in memory was observed after GA (-0.065, P < .001) but not RA (-0.011, P = .565).
Older adults undergoing surgery with RA experience decline of global cognition similar to those receiving GA; however, memory was not affected.
我们的目的是检验在区域麻醉（RA）下进行手术是否与先前报道的全身麻醉（GA）后相似的加速长期认知衰退有关。
对 1819 名老年患者的队列进行了纵向认知功能分析。模型评估了暴露于 RA 或 GA 下的参与者在不同时间的整体和特定领域认知的变化率。
与未接受麻醉的患者相比，接受 RA（每年下降差异为-0.041，P=0.011）和 GA（-0.061，P<0.001）的患者术后认知总体 z 分数的变化率更大；这些变化率没有差异。在特定领域评分的分析中，GA 后观察到记忆的加速下降（-0.065，P<0.001），而 RA 后则没有（-0.011，P=0.565）。
接受 RA 下手术的老年患者经历的整体认知下降与接受 GA 者相似；然而，记忆并未受到影响。
