Effect of general anesthesia on parturients’ cognitive functions after cesarean section

Abstract

Different general anaesthetics do damage on psychic, which is manifested in the postoperative period as cognitive dysfunction. The functions of attention, short-term memory, psychomotor speed and cognitive reactions are the most vulnerable to the action of general anaesthetics. The problem of postoperative cognitive dysfunction is relevant in obstetrics as well. Objective – is to study the effects of general anaesthesia techniques (total intravenous versus inhalation) in cesarean section on memory, perception and speach. Materials and methods. Having agreed with local ethics committee and obtained informed consent, 64 pregnant women (at 37-42 weeks of gestation, who had delivered by the cesarean section) were examined. The women were divided into two groups depending on maintenance of anaesthesia. The 1st group (n=30) was prescribed with inhalation anaesthesia with sevofluran. The 2nd group (n = 34) received total intravenous anaesthesia. Memory was assessed by Luria’s test; the perception was assessed by the test of time recognition, speech was evaluated by a "naming fingers" test. The results and conclusions. Initially decreased level of memory in women regressed after the operative delivery with postoperative period’s time increasing. Memory recovered by the 3rd day after the cesarean section, regardless anaesthesia techniques. Memory value after inhalation anesthesia exceeds that after total intravenous anesthesia by 5-7th day after surgery. The level of perception in parturients does not significantly depend on the postoperative period. The anesthesia technique affects speech recovery after delivery by cesarean section. It normalized by 5-7th day after inhalation anesthesia, remaining for total intravenous anesthesia below normal.