The effect of anaesthesia on the cognitive function of the post-hospital stasis

As a result of the ageing population, the number of geriatric artery replacements is increasing. The impact of anaesthesia on the post-operative cognitive function of older patients, as a key part of the operation, has received widespread attention. It is important to understand this impact in order to optimize anaesthesia programmes and improve the quality of life of elderly patients after surgery. 1. Physical characteristics and cognitional susceptibility of older patients (i) the central nervous system of older patients has undergone a withdrawal, with reduced brain blood flow, reduced number of neurons and changes in neurotransmitters. At the same time, the reduced functioning of the cardiovascular system, such as reduced heart output, reduced respiratory function such as pulmonary adaptability, abdominal/blood flow disorder, etc., have reduced the tolerance of elderly patients for anesthesia and surgery. (ii) There may be different levels of cognitive impairment pre-opportunity for cognitive impaired elderly patients, including mild cognitive impairment, dementia, etc. Surgery and anaesthesia stress can further exacerbate the impairment of this cognitive function, in the form of post-surgery, loss of memory, low concentration, etc. ii. Application of the usual anaesthesia method in the gerontological joint replacement procedure (i) whole body anesthesia 1. Mechanisms of drug selection and functioning: common inhalation of anaesthesia (e.g., heptafluoroalkanes) and intravenous anaesthesia (e.g., propol). Inhalation of anaesthesia can affect brain blood flow and metabolism, and intravenous anesthesia works mainly through receptors of the central nervous system. The whole body anesthesia provides good operating conditions, but the effects of the drug on the central nervous system may continue beyond the operation. 2. Potential effects on cognitive function: The whole body of narcotic drugs may affect cognitive function in a number of ways. For example, inhibiting the central choline energy system affects the transmission of neurotransmitters, leading to post-operative cognitive dysfunction. In addition, hemodynamic fluctuations during anaesthesia induction and awakening, such as low blood pressure and low oxygen haemorrhage, can damage brain infusion and oxygen supply and increase cognitive impairment. (ii) The principles and advantages of anaesthesia in the vertebrae, including epidural anesthesia and anaesthesia under the spider membrane, with the effect of anaesthesia through neurotransmission. In the geriatric cortex replacement procedure, vertebral anesthesia reduces overall stress and has a relatively small effect on the respiratory and circulatory system. 2. Impact on cognitive function: Anesthesia in vertebrates may reduce the incidence of post-operative cognitive impairment. This may be due to lower direct interference with the central nervous system by anaesthesia in the vertebrates and better maintenance of hemodynamic stability and reduction of under-infusion due to low blood pressure etc. However, there may also be adverse effects on cognitive functions in cases of high levels of anaesthesia and low blood pressure. III. The effect of anaesthesia-related factors on the post-operative cognitive function of elderly patients (i) the depth of anaesthesia, whether in the body or in the vertebrae, is of paramount importance for the control of the depth of anaesthesia. Excessive anesthesia can lead to excessive brain metabolic inhibition and increase the risk of post-operative cognitive impairment. Over anaesthesia, on the other hand, can give rise to knowledge and stress in the patient ‘ s surgery, and is not conducive to the protection of cognitive functions. The adjustment of the depth of the anaesthesia can be guided by monitoring tools such as the Brain Double Frequency Index (BIS). (ii) The length of anesthesia surgery and the length of anesthesia increases the incidence of post-operative cognitive disorders among elderly patients. Long periods of anaesthesia increase the exposure of patients to anaesthesia, while increasing the probability of adverse events such as low blood pressure and low osteoporosis, with a more severe impact on cognitive functions. (iii) Low blood pressure in surgery and low aerobic haematoma are important risk factors for post-operative cognitive disorders in older patients. Blood pressure and O2 saturation should be closely monitored during anaesthesia, low blood pressure and low oxygen haemorrhage should be corrected in a timely manner, and brain infusion and oxygen supply maintained. IV. Strategies to prevent the effects of anaesthesia on the cognitive function of post-hospital transfer (i) Optimizing anaesthesia programmes to select appropriate anaesthesia methods and drugs based on the patient ‘ s state of health, type of operation and estimated length of operation. In the case of elderly patients, priority may be given to intravertebrate anaesthesia or to the use of short-activated narcotic drugs that have little effect on cognitive functions. At the same time, the rational joint use of narcotic drugs reduces the dose of a single drug. (ii) To strengthen the use of advanced monitoring equipment in monitoring and management techniques, such as BIS, primary or no-generation blood pressure monitoring, and haemosic saturation monitoring, to monitor in real time the depth of anaesthesia, blood flow mechanics and oxidation of patients. Timely adjustment of the depth of anaesthesia and treatment of abnormalities such as low blood pressure and low oxygen haemorrhage. Anaesthesia has a significant impact on the cognitive function of post-hospital cosmosis. Both the general anesthesia and the intravertebrate anesthesia have characteristics and potential effects on cognitive function. An improved understanding of the physical characteristics of older patients, the optimization of anaesthesia programmes and the strengthening of surgical monitoring and post-operative management can reduce the incidence of post-aesthetic-related cognitive disorders and improve the quality of rehabilitation and the quality of life of older patients after the transfer of joints.