Influence of inhalation anesthesia in caesarean section on parturients’ cognitive functions.

Authors

  • O. O. Volkov

DOI:

https://doi.org/10.26641/2307-0404.2015.2.45667

Keywords:

caesarian section, cognitive functions, inhalation anesthesia

Abstract

General anaesthesia may be the cause of different damages of the nervous system after surgery. Anaesthesia technique may be preventive factor of developing or worsening postoperative cognitive disfunctions. A research aim was to study an influence of inhalation anaesthesia during the caesarean section on the parturients’ cognitive functions. Having agreed with local ethics committee and obtained informed consent,30 pregnants (at 37-42 weeks of gestation (38,9 (0,76), those who underwent caesarian section) were examined. Inhalation anaesthesia: induction - thiopental sodium (5 mgs/kg), maintenance - sevofluran 1,3 vol.%, in fresh gas flow 1,5 L/min. Relaxation – suxcinilcholinum (1-1,5 mgs/ kg). Phentanyl (0,05 mgs/of ml - 4 mls) and diazepamum (10 mgs) after newborn extraction were introduced. Mainte­nance of analgesia is phentanyl in the dose of 0,05 mg/ml – 1 ml in approaching of BIS to 60 (BISX Module, BIS™ Co­vidient, the USA). We used Montreal Cognitive Assessment (MoCA) test – for cognitive functions investigation, “Matching digits and letters” test for control functions, Luria’s test for memory, perception was studied by test “recognition of time”. Speech was studied by test "name of fingers", praxis by “drawing of clock” test. Control points: 1 - upon admission to the obstetrical department (P1), 24hours after the surgery (P2), on the day 3 after the surgery (P3), on the day 5-7 after the surgery (P4). The study showed that in 24 hours after caesarean section under inhalation anaesthesia the meanings of cognitive functions did not change in general, and were kept on predelivery values. Under inhalation anaesthesia cognitive functions are normalized on day 3 of postoperative period. Perception level does not depend on the time after surgery. Initially decreased memory level in expectant mothers was regressed after operative delivery and recovers by the day 3 after surgery. Speech normalizes by days 5-7 after inhalation anaesthesia in caesarean section, and praxis remains decreased.

Author Biography

O. O. Volkov

Municipal Institution “Dniprodzerzhynsk City Hospital N 9” of Dnipropetrovsk Regional Council
Anoshkina av., 72, Dniprodzerzhynsk, Dnipropetrovsk region, 51900, Ukraine

References

Loskutov OA, Sudakevich SN, Todurov BM, Shla¬pak IP. [Effect of depth of anesthesia on the deve¬lopment of postoperative cognitive dysfunction]. Emer¬gency Medicine. 2013;54(7). Available from: http://www.mif-ua.com/archive/article_print/37554. Ukrainian. 2. Usenko LV, Shady Ade Rizk, Krishtafor AA, Ka¬njuka GS, Kushch IP. [Prevention and correction of post¬operative cognitive dysfunctions in elderly patients (metho¬dical recommendations)]. Dnepropetrovsk: DGMA, 2008;60. Russian. 3. Shnayder NA, Shprah VV, Salina AB. Posto¬pera¬tive cognitive dysfunctions (diagnostics, prophylaxis, treat¬ment). Conference "computer NT". Krasnoyarsk, 2005;95. 4. Anderson MV. Cognitive reorganization and protective mechanisms in pregnancy and the postpartum period. Open Access Dissertations and Theses. 2012; Paper 6882. Available from: ttp://digitalcom¬mons.mcmaster.ca/opendissertations 5. Bruggemans EF. Cognitive dysfunction after cardiac surgery: Pathophysiological mechanisms and preventive strategies. Neth. Heart. J. 2013;21(2):70-73. 6. Ghosh S. The possibility of postoperative cog¬nitive dysfunction in obstetric anaesthesia following caesarean section. Eropean Jornal of Anaesthesiology. 2012;29(2):61–63. 7. Declercq E, Young R, Cabral H, Ecker J. Is a rising cesarean delivery rate inevitable? Trends in in¬dustrialized countries, 1987 to 2007. Birth. 2011;38(2):99-104. 8. Neuman S, Stygall J, Hurani C. Postoperative cognitive dysfunction after noncardiac surgery: a systematic review. Anesthesiology. 2007;106(3):572-90. 9. Coburn M, Fahlenkamp A, Zoremba N. Posto¬perative cognitive dysfunction: Incidence and prophy¬laxis. Anaesthesist. 2010;59(2):177-84. 10. Monk TG, Weldon BC, Garvan CW. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology. 2008;108(1):18-30. 11. Parsons TD, Thompson E, Buckwalter DK, Blu¬es¬tein BW. Pregnancy history and cognition during and after pregnancy. Intern. J. Neuroscience. 2004;114:1099-110. 12. Rasmussen LS. Postoperative cognitive dysfunc¬tion: incidence and prevention. Best Pract Res Clin Anaesthesiol. 2006;20(2):315-30.

Downloads

Published

2015-06-08

How to Cite

1.
Volkov OO. Influence of inhalation anesthesia in caesarean section on parturients’ cognitive functions. Med. perspekt. [Internet]. 2015Jun.8 [cited 2024Apr.23];20(2):78-84. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/45667

Issue

Section

CLINICAL MEDICINE