General anesthesia combined with epidural anesthesia on the postoperative cognitive functions in pregnant women with dystocia

Fu,Min; Li,Dongdong

doi:10.3892/etm.2018.6277

General anesthesia combined with epidural anesthesia on the postoperative cognitive functions in pregnant women with dystocia

Authors:
- Min Fu
- Dongdong Li
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Affiliations: Department of Anesthesiology, Yidu Central Hospital of Weifang, Qingzhou, Shandong 262500, P.R. China
Published online on: June 8, 2018 https://doi.org/10.3892/etm.2018.6277
Pages: 1149-1152

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Abstract

Effects of general anesthesia combined with epidural anesthesia on the postoperative cognitive functions in pregnant women with dystocia were investigated. Postoperative cognitive functions of 84 dystocia pregnant women treated with cesarean section were retrospectively analyzed. Patients who received general anesthesia were included in group A (n=42), and those who received general anesthesia combined with epidural anesthesia were included in group B (n=42). Mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS) at different time-points after anesthesia in the two groups of patients were observed and compared. Recovery of anesthesia such as the recovery time of spontaneous breathing, recovery time of orientation and time of eye opening were observed and compared between two groups of patients. Mini mental state examination (MMSE) scores were obtained and compared between the the groups of patients at different time-points after operation. Three vital signs (MAP, HR and BIS) were not significantly different between group A and B at the same time-point (P>0.05) and the maintenance of anesthesia was satisfactory. Compared with group A, postoperative recovery time of spontaneous breathing, recovery time of orientation and the time of eye opening in group B were all significantly shorter (P<0.05). In addition, MMSE scores of patients in group B, 2 and 12 h after operation were 24.33±1.61 and 26.41±1.83 points, respectively, which were significantly improved compared with those of patients in group A (20.45±1.58 and 22.39±1.72 points, respectively) (P<0.05). In conclusion, recovery of postoperative cognitive functions in pregnant women with dystocia who received general anesthesia combined with epidural anesthesia was shorter to that of those who only received general anesthesia.

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1	Wu E, Clair K and Chan K: Compliance with contemporary guidelines for the diagnosis of labor dystocia by stage of labor [22O]. Obstet Gynecol. 129:S158–S159. 2017. View Article : Google Scholar
2	Simkin P, Hanson L and Ancheta R: The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia. 4th edition. John Wiley & Sons, Inc.; Hoboken, NJ: 2017
3	Szymanski L, Arnold C, Vaught AJ, LaMantia S, Harris T and Satin AJ: Implementation of a multicenter shoulder dystocia injury prevention program. Semin Perinatol. 41:187–194. 2017. View Article : Google Scholar : PubMed/NCBI
4	Murphy M, Robson M, Brennan D, Butler M, Coughlan B and O'Herlihy C: 610: Amniotic fluid lactate (AFL) at diagnosis of labour predicts dystocia and caesarean section (CS) in spontaneously labouring single cephalic nulliparous women ≥37 weeks gestation (SSCNT). Am J Obstet Gynecol. 210:S2992014. View Article : Google Scholar
5	Clair K, Wu E and Chan K: Compliance with contemporary criteria for the diagnosis of labor dystocia by time of day [23O]. Obstet Gynecol. 129:S1592017. View Article : Google Scholar
6	Benzaquen M, Galvão KN, Coleman AE, Santos JE, Goff JP and Risco CA: Effect of oral mineral and energy supplementation on blood mineral concentrations, energetic and inflammatory profile, and milk yield in dairy cows affected with dystocia. Vet J. 204:186–191. 2015. View Article : Google Scholar : PubMed/NCBI
7	Ouerghi S, Bougacha MA, Frikha N, Mestiri T, Ben Ammar MS and Mebazaa MS: Combined use of crystalloid preload and low dose spinal anesthesia for preventing hypotension in spinal anesthesia for cesarean delivery: A randomized controlled trial. Middle East J Anaesthesiol. 20:667–672. 2010.PubMed/NCBI
8	Foss VT, Christensen R, Rokamp KZ, Nissen P, Secher NH and Nielsen HB: Effect of phenylephrine vs. ephedrine on frontal lobe oxygenation during caesarean section with spinal anesthesia: An open label randomized controlled trial. Front Physiol. 5:812014. View Article : Google Scholar : PubMed/NCBI
9	Zheng W, Sun Z and Liu Z: A comparative study on sedative effect of dexmedetomidine and midazolam in drunken patients after general anesthesia. Chinese J Postgraduates Med. 38:909–912. 2015.
10	Chiao S and Zuo Z: A double-edged sword: Volatile anesthetic effects on the neonatal brain. Brain Sci. 4:273–294. 2014. View Article : Google Scholar : PubMed/NCBI
11	Nash DM, Mustafa RA, McArthur E, Wijeysundera DN, Paterson JM, Sharan S, Vinden C, Wald R, Welk B, Sessler DI, et al: Combined general and neuraxial anesthesia versus general anesthesia: A population-based cohort study. Can J Anaesth. 62:356–368. 2015. View Article : Google Scholar : PubMed/NCBI
12	He ZY, Jiao QL, Miao Y and Sun Y: Clinical application of combined anesthesia in cesarean section. Pak J Pharm Sci. 28:2327–2330. 2015.PubMed/NCBI
13	Snell JJ, Chan DM and McClain CD: Primum non nocere: Advocating for a better model in global surgery and anesthesia. J Anesth Hist. 3:1–2. 2017. View Article : Google Scholar : PubMed/NCBI
14	Maheshwari K, You J, Cummings KC III, Argalious M, Sessler DI, Kurz A and Cywinski J: Attempted development of a tool to predict anesthesia preparation time from patient-related and procedure-related characteristics. Anesth Analg. 125:580–592. 2017. View Article : Google Scholar : PubMed/NCBI
15	Whitaker EE, Wiemann BZ, DaJusta DG, Alpert SA, Ching CB, McLeod DJ, Tobias JD and Jayanthi VR: Spinal anesthesia for pediatric urological surgery: Reducing the theoretic neurotoxic effects of general anesthesia. J Pediatr Urol. 13:396–400. 2017. View Article : Google Scholar : PubMed/NCBI
16	Rappaport BA, Suresh S, Hertz S, Evers AS and Orser BA: Anesthetic neurotoxicity - clinical implications of animal models. N Engl J Med. 372:796–797. 2015. View Article : Google Scholar : PubMed/NCBI
17	Bajrektarevic D and Nistri A: Delayed application of the anesthetic propofol contrasts the neurotoxic effects of kainate on rat organotypic spinal slice cultures. Neurotoxicology. 54:1–10. 2016. View Article : Google Scholar : PubMed/NCBI
18	Xu Q, Zhang H, Zhu YM and Shi NJ: Effects of combined general/epidural anesthesia on hemodynamics, respiratory function, and stress hormone levels in patients with ovarian neoplasm undergoing laparoscopy. Med Sci Monit. 22:4238–4246. 2016. View Article : Google Scholar : PubMed/NCBI
19	Millar K, Bowman AW, Burns D, McLaughlin P, Moores T, Morton NS, Musiello T, Wallace E, Wray A and Welbury RR: Children's cognitive recovery after day-case general anesthesia: A randomized trial of propofol or isoflurane for dental procedures. Paediatr Anaesth. 24:201–207. 2014. View Article : Google Scholar : PubMed/NCBI
20	Liu Y, Pan N, Ma Y, Zhang S, Guo W, Li H, Zhou J, Liu G and Gao M: Inhaled sevoflurane may promote progression of amnestic mild cognitive impairment: A prospective, randomized parallel-group study. Am J Med Sci. 345:355–360. 2013. View Article : Google Scholar : PubMed/NCBI
21	Zywiel MG, Prabhu A, Perruccio AV and Gandhi R: The influence of anesthesia and pain management on cognitive dysfunction after joint arthroplasty: A systematic review. Clin Orthop Relat Res. 472:1453–1466. 2014. View Article : Google Scholar : PubMed/NCBI
22	Wang Y, Liu X and Li H: Incidence of the post-operative cognitive dysfunction in elderly patients with general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 41:846–851. 2016.(In Chinese). PubMed/NCBI
23	Shi HJ, Xue XH, Wang YL, Zhang WS, Wang ZS and Yu AL: Effects of different anesthesia methods on cognitive dysfunction after hip replacement operation in elder patients. Int J Clin Exp Med. 8:3883–3888. 2015.PubMed/NCBI