Effects of anesthesia type on short-term postoperative cognitive function in obstetric patients following cesarean section

Abstract

Objective: We aimed to compare the effects of general and spinal anesthesia on cognitive functions in pregnant patients undergoing elective cesarean section.

Material and methods: Seventy-five American Society of Anesthesiology (ASA) I pregnant patients aged 18-40 years who were scheduled to undergo elective cesarean section were divided into three groups. Group sevoflurane (Group S) and Group desflurane (Group D) were administered general anesthesia, whereas Group regional (Group R) was administered spinal anesthesia. Hemodynamic variables, bispectral index, oxygen saturation were measured at baseline, after induction, spinal injection, and during the surgery. Extubation and eye opening time and Aldrete scores were recorded. Mini-mental state examination, Trieger dot test, and clock drawing test were performed one day before the surgery and repeated at the 1(st), 3(rd) and 24(th) h postoperatively.

Results: There was no statistically significant difference among the groups in terms of demographic data and duration of surgery (p>0.05). Durations of anesthesia for Group S, Group R, and Group D were significantly different (p<0.05). Duration of anesthesia for Group R was significantly longer than for Groups S and D (p<0.0001). Aldrete recovery scores and total remifentanil consumption were significantly higher in Group D than in Group S (p<0.05). Extubation and eye opening times were significantly shorter in Group D than in Group S (p<0.01). According to TDT, statistical significance was found among Group S, Group R, and Group D at the 3rd and 24th h postoperatively (p<0.05), and there was a statistically high significant difference in Groups S and R (p<0.0001).

Conclusion: We concluded that general anesthesia with sevoflurane or desflurane and spinal anesthesia had no effects on cognitive functions in patients undergoing cesarean operation.

Keywords: Sevoflurane; cesarean section; cognitive function; desflurane; general anesthesia; spinal anesthesia.

Figure 1

Heart rate (HR) of the patients (Mean±SD)

Figure 2

Mean arterial pressure (MAP) of the patients (Mean±SD)

Figure 3

Bispectral index (BIS) values of the patients (Mean±SD)

Figure 4

Mini-mental state examination (MMSE) of the patients (Mean±SD)

Figure 5

Trieger dot test (TDT) of the patients (Mean±SD)

Figure 6

Clock drawing test (CDT) of the patients (Mean±SD)