Abstract: ［Abstract］  Objective〖HTSS〗〓To investigate the influence of combined epidural and general anesthesia in elderly patients to concentrations of melatonin and its correlation with emergence delirium.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty elderly patients undergoing gastric cancer surgery were divided into epidural anesthesia compound general anesthesia(ET) group and general anesthesia(T) group, 30 patients each. The ET group was given epidural anesthesia, 15 min later, both groups were treated with general anesthesia. Melatonin concentration, cognitive function score and postoperative restlessness score were compared between the two groups.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The urine volume, general anesthetic propofol dosage of ET group were less than T group, as well as recovery time, waking time, breathing time, extubation time of ET group were less than T group(P＜005). The melatonin concentration increased between two groups, and the ET group increased more. And among groups, different time pionts and at different time points between groups, the difference was statistically significant(P＜005). The minimental state examinatlon score of the two groups showed a trend of decreasing first and then increasing, the change of ET group was smaller, and the difference between the two groups was statistically significant(P＜005). The agitation score of recovery period in ET group was significantly lower than that in T group(P＜005). There was a negative correlation between the agitation score of recovery period and the concentration of melatonin, melatonin changes and body weight(P＜005), and was positively correlated with the amount of urine, the time of recovery and the amount of propofol(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Epidural anesthesia combines the advantages of general anesthesia and epidural anesthesia, had analgesia both in intraoperative and postoperative, can stable hemodynamics, reduce the amount of anesthetic, maintain postoperative plasma fade melanin concentration, reduce postoperative restlessness, shorten hospital stay and improve prognosis. It is worthy of clinical promotion.

Key words: stomach neoplasms, anesthesia, general, melatonin, delirium