IMPACT OF INTRA-OPERATIVE SEDATION WITH SPINAL ANESTHESIA DURING UTERUS AMPUTATION ON COGNITIVE FUNCTIONS IN THE POST-OPERATIVE PERIOD

Abstract

The post-operative cognitive dysfunction is an adverse disorder of higher functions of the nervous system, which develops in the post-operative period and it is associated with surgery and anesthesia. The goal: to investigate the impact of sedation through spinal anesthesia on the frequency of the post-operative cognitive dysfunction after uterus amputation. Subjects and methods. 65 middle age women were examined, they all had the uterus amputated with spinal anesthesia with 15-20 mg of 0.5% hyperbaric solution of bupivicaine. Dexmedetomidine (0.5-1.2 mcg/kg per 1 hour) was used in the patients from Group 1 (28 women), and propofol (2-10 mg/kg per 1 hour) was used in Group 2 (37 women). Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used for assessment of cognitive functions before and after the surgery. Results. The statistically significant difference in the level of cognitive functions was observed between the Groups on the 1st and 5th day after the surgery. The level of cognitive functions was statistically significantly higher in the group where dexmedetomidine was used versus the group where propofol was used, which provided the evidence of the minimum negative effect of spinal anesthesia with dexmedetomidine on the cognitive potential in the patients undergoing gynecological surgery. Conclusion: Spinal anesthesia with dexmedetomidine during uterus amputation reduces the risk of the post-operative cognitive dysfunction.

Keywords

• spinal anesthesia
• intra-operative sedation
• uterus amputation
• post-operative cognitive dysfunction
• dexmedetomidine
• propofol