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

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. Mainte ­ nance of analgesia is phentanyl in the dose of 0,05 mg/ml – 1 ml in approaching of BIS to 60 (BISX Module, BIS™ Co ­ vidient, 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.