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A Comparative Study of Pregnant Patients with Cardiac Disease undergoing General Anesthesia Versus Regional Anesthesia in View of Post-operative Neurocognitive Dysfunction after Cesarean Section

Vaibhao A Dongre , Gopal Divya1 , Vaibhao A Dongre2 , Manjula Sarkar3

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Indian Journal of Anesthesia and Analgesia 6(6):p 1936-1943, November-December 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.9

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Gopal Divya, Vaibhao A Dongre, Manjula Sarkar. A Comparative Study of Pregnant Patients with Cardiac Disease undergoing General Anesthesia Versus Regional Anesthesia in View of Post-operative Neurocognitive Dysfunction after Cesarean Section. Indian J Anesth Analg. 2019;6(6 Part -I):1936-1943.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Aim: Our aim was to comparatively evaluate the post-operative neurocognitive dysfunction following general and regional anesthesia in pregnant patients with cardiac disease undergoing elective cesarean section. Materials and Methods: Sixty pregnant patients with congenital or rheumatic heart disease undergoing elective cesarean section were divided into two groups, General anesthesia group (Group G, n = 30) and Regional Anesthesia Group (Group R, n = 30). Neuro-Cognitive Tests - Trail Making test A & B, Digit symbol substitution test, Benton visual retention test and Benton visual recognition test were performed one day prior to surgery and at 6h, on day 1 and day 3 post-operatively. Results: Neuro-cognitive tests when compared from their preoperative values to 6h, day 1 and day 3 post-operatively, there was a significant increase (p <-0.001) in both Groups G and Group R. Whereas when compared between the Group G and Group R at pre-operative, 6h, day 1 and day 3 post-operatively there was no significant difference between them (p > 0.05). Cognitive dysfunction occurred in both the groups but it was short lasting in Group R. Post-operative cognitive dysfunction incidence in Group G was 23% as compared to 10% in Group R on day 3. Conclusion: Neurocognitive functions are affected in post-operative pregnant patients with cardiac disease irrespective of the technique of anesthesia. However, recovery is delayed in patients receiving general anesthesia.  

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Gopal Divya, Vaibhao A Dongre, Manjula Sarkar. A Comparative Study of Pregnant Patients with Cardiac Disease undergoing General Anesthesia Versus Regional Anesthesia in View of Post-operative Neurocognitive Dysfunction after Cesarean Section. Indian J Anesth Analg. 2019;6(6 Part -I):1936-1943.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.9

Keywords

Cardiac disease; Epidural anesthesia; General anesthesia; Post-operative cognitive dysfunction.

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