Comparison of the effect of combined general and regional anesthesia on the cognitive functions of women of reproductive age: retrospective observational study

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.