Objective  To investigate the effect of general anesthesia and combined spinal and epidural anesthesia on cognitive function in elderly patients with lower extremity fractures.

  Methods  A total of 80 patients who underwent surgery for lower extremity fractures were randomly divided into two groups. Patients in the general anesthesia group received general anesthesia, and those in the combined anesthesia group underwent combined spinal and epidural anesthesia. Perioperative vital signs monitoring results, pain, comfort, cognitive level, related anesthesia indicators and safety were compared.

  Results  Systolic blood pressure(SBP) and mean arterial pressure (MAP) levels at T₂, T₃, T₄ and T₅ in the combined anesthesia group were significantly higher than those in the general anesthesia group. The Visual Analogue Scale(VAS) scores immediately after surgery, at 1 and 3 d were significantly lower, Comfort Status Scale (BCS) score and Mini-mental State Examination (MMSE) scores were significantly higher than that in the general anesthesia group; the time of eating, the number of analgesic pump presses, the time of bed-off and the postoperative24 h sufentanil remediation rate were significantly lower than that in the general anesthesia group; overall incidence of adverse reactions was lower than that in the general anesthesia group, and the differences were statistically significant (P < 0.05).

  Conclusion  General anesthesia combined with spinal-epidural anesthesia has significant effect for patients with lower limb fractures.