Comparison of the effect of combined general and regional anesthesia on the cognitive functions of women of reproductive age: retrospective observational study
- Authors: Chernykh O.A.1, Lakhin R.E.1, Shchegolev A.V.1
-
Affiliations:
- Kirov Military Medical Academy
- Issue: Vol 17, No 2 (2023)
- Pages: 115-123
- Section: Original articles
- URL: https://journals.rcsi.science/1993-6508/article/view/134214
- DOI: https://doi.org/10.17816/RA321363
- ID: 134214
Cite item
Abstract
BACKGROUND: Depression and cognitive dysfunction in the postoperative period may be associated with pregnancy, surgery, and type of anesthetic support.
OBJECTIVE: To perform a comparative assessment of the effect of combined general and regional anesthesia on memory and attention in pregnant and nonpregnant women.
MATERIALS AND METHODS: The study involved 120 women of reproductive age who were admitted for surgery. According to the indications, they received various anesthesia types depending on their somatic status. The cognitive potential of the patients and indicators of memory and attention, anxiety, and depression were evaluated using specially selected tests before surgery and three days after surgery. The effect of anesthesia on pregnant women during planned operative delivery was studied, and planned interventions in gynecology were used for comparison.
RESULTS: The MOS test scores in all groups were reduced, and they indicated a reduced cognitive potential in nonpregnant women [26.2 (26.9; 25.5) and 24 (24.59; 23.44)] under general anesthesia (p <0.003) and pregnant women [25.2 (25.7; 24.7) and 24.6 (25.36; 23.84)] under general anesthesia (p <0.004). After the operation under OA, the results worsened, and statistical differences were revealed. The level of attention in pregnant women decreased according to the results of the Wexler test after surgery in the general anesthesia group [4.5 (5.1; 3.9) and 3 (3.46; 2.54), p <0.006], and in the regional anesthesia group, the results decreased but to a lesser extent degree [5 (5.8; 4.2) and 3.5 (4.2; 2.8, p <0.005], showing statistical difference. According to the results of the Benton test after surgery in the general anesthesia group, visual short-term memory decreased in pregnant women [6.15 (6.75; 5.55) and 4 (4.86; 3.14), p <0.002], and in the regional anesthesia group, the results decreased, but to a lesser extent [6.2 (6.9; 5.5) and 4.5 (5.2; 3.8, p <0.012], and statistical differences were noted.
CONCLUSION: The effect of combined general and regional anesthesia led to the development of cognitive dysfunction, increased depression, and changes in memory and attention.
Full Text
##article.viewOnOriginalSite##About the authors
Oksana A. Chernykh
Kirov Military Medical Academy
Author for correspondence.
Email: ksemykina@yandex.ru
ORCID iD: 0000-0003-1236-7873
anaestesiologist
Russian Federation, St. PetersburgRoman E. Lakhin
Kirov Military Medical Academy
Email: doctor-lahin@yandex.ru
ORCID iD: 0000-0001-6819-9691
SPIN-code: 7261-9985
MD, Dr. Sci. (Med.), department professor
Russian Federation, St. PetersburgAlexey V. Shchegolev
Kirov Military Medical Academy
Email: alekseischegolev@gmail.com
ORCID iD: 0000-0003-4353-4953
SPIN-code: 4107-6860
MD, Dr. Sci. (Med.), Professor, department head
Russian Federation, St. PetersburgReferences
- Ovezov AM, Panteleeva MV, Knyazev AV, et al. Cognitive dysfunction and general anesthesia: from pathogenesis to prevention and correction. Neurology, Neuropsychiatry, Psychosomatics. 2016;8(3):101–105. (In Russ). doi: 10.14412/2074-2711-2016-3-101-105
- Polushin YS, Polushin AY, Yukina GY, Kojemyakina MV. Postoperative cognitive dysfunction — what we know and where to move next. Messenger of Anesthesiology and Resuscitation. 2019;16(1):19–28. (In Russ). doi: 10.21292/2078-5658-2019-16-1-19-28
- Kulikov AV, Ovezov AM, Shifman EM. Anesthesia during cesarion section. Russian Journal of Anaesthesiology and Reanimatology. 2018;(4):83–99. (In Russ). doi: 10.17116anaesthesiology201804183
- Ackenbom MF, Butters MA, Davis EM, et al. Incidence of postoperative cognitive dysfunction in older women undergoing pelvic organ prolapse surgery. Int Urogynecol J. 2021;32(2):433–442. doi: 10.1007/s00192-020-04495-у
- Bhushan S, Huang X, Duan Y, Xiao Z. The impact of regional versus general anesthesia on postoperative neurocognitive outcomes in elderly patients undergoing hip fracture surgery: A systematic review and meta-analysis. Int J Surg. 2022;105:106854. doi: 10.1016/j.ijsu.2022.106854
- Davis N, Lee M, Lin AY, et al. Postoperative cognitive function following general versus regional anesthesia: a systematic review. J Neurosurg Anesthesiol. 2014;26(4):369–376. doi: 10.1097/ANA.0000000000000120
- Zhang X, Dong Q, Fang J. Impacts of General and Spinal Anaesthesia on Short-Term Cognitive Function and Mental Status in Elderly Patients Undergoing Orthopaedic Surgery. J Coll Physicians Surg Pak. 2019;29(2):101–104. doi: 10.29271/jcpsp.2019.02.101
- Belova AN, Prusakova ZhB, Zagrekov VI, Ezhevskaya AA. Alzheimer’s disease and anesthesia. Advances in Current Natural Sciences. 2015;8:7–13. (In Russ).