Dataset Information

Early Postoperative Cognitive Dysfunction in Women Undergoing Elective and Emergent Caesarian Section under General Anaesthesia: A Comparative Study.

ABSTRACT:

Background

Postoperative cognitive dysfunction (POCD) following cesarean section (CS) is a growing and underestimated problem with unknown mechanisms. Studies suggest that general anesthesia (GA) plays a role in the development of early POCD.

Objectives

This study aimed to assess the incidence of early POCD after elective and emergent CS under GA.

Methods

We assessed the difference between the elective and emergent groups regarding the mini-mental state examination (MMSE), hemodynamic effects such as mean blood pressure (MBP), and heart rate (HR). Paired t-test was applied for intragroup comparison, and Student's t-test (or Mann-Whitney U test, as appropriate) for intergroup comparison.

Results

MMSE one hour after the operation was significantly lower than preoperative MMSE in the emergent group, and the MMSE tended to return to normal values faster in the elective than in the emergent group. Moreover, we found a significantly lower MBP and higher HR (at 15, 30, and 45 minutes) in both groups compared to preoperative values. Regarding intergroup comparison, MBP (at 30 minutes) significantly decreased in the elective group compared to the emergent group.

Conclusions

There was a significantly lower POCD, especially at the first hour postoperatively, in the elective CS than in the emergent CS. Elective CS might have a positive effect on the women's health as a mode of delivery.

SUBMITTER: Bahr MH

PROVIDER: S-EPMC10016137 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Early Postoperative Cognitive Dysfunction in Women Undergoing Elective and Emergent Caesarian Section under General Anaesthesia: A Comparative Study.

Bahr Mahmoud Hussein MH Elgamel Amira Fouad AF Ahmed Ahmed Goda AG Abdelkader Mohamed M

Anesthesiology and pain medicine 20220801 4

<h4>Background</h4>Postoperative cognitive dysfunction (POCD) following cesarean section (CS) is a growing and underestimated problem with unknown mechanisms. Studies suggest that general anesthesia (GA) plays a role in the development of early POCD.<h4>Objectives</h4>This study aimed to assess the incidence of early POCD after elective and emergent CS under GA.<h4>Methods</h4>We assessed the difference between the elective and emergent groups regarding the mini-mental state examination (MMSE), ...[more]

PMID: 36937083

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Project description:BackgroundNeuroprotective effects of dexmedetomidine are reported in preclinical and clinical studies but evidence regarding the postoperative neurocognitive function is still unclear. This study performed a meta-analysis on outcomes of studies which examined neurocognitive performance and inflammatory factors to investigate the effects of dexmedetomidine on postoperative cognitive dysfunction (POCD) and inflammation in patients after general anaesthesia.MethodsLiteratures were searched in several electronic databases and studies were selected by following precise inclusion criteria. We searched PubMed, EMBASE, the Cochrane Library, China Academic Journals full-text database (CNKI), and Google Scholar to find randomized controlled trials (RCTs) of the influence of dexmedetomidine on POCD and inflammation in patients who had undergone general anaesthesia. Two researchers independently screened the literature, extracted data, and evaluated quality of methodology against inclusion and exclusion criteria. Meta-analyses of pooled ORs of POCD incidences and mean differences in neurocognitive assessment scores and inflammation levels were carried out and subgroup analyses were performed. Stata 12.0 was used to conduct our meta-analysis.ResultsTwenty-six RCTs were included. Compared with controls, perioperative dexmedetomidine treatment significantly reduced the incidence of POCD (pooled ORs = 0.59, 95% confidence interval (CI) 0.45-2.95) and improved Mini-Mental State Examination (MMSE) score (standardized mean difference (SMD) = 1.74, 95% CI 0.43-3.05) on the first postoperative day. Furthermore, perioperative dexmedetomidine treatment significantly decreased IL-6 (SMD = -1.31, 95% CI -1.87-0.75, P < .001) and TNF-α (SMD = -2.14, 95% CI -3.14-1.14, P < .001) compared to saline/comparators treatment. In the stratified analysis by surgical type, age, type of control, and study region, the differences were also significant between dexmedetomidine- and saline-treated patients.ConclusionPerioperative dexmedetomidine treatment is associated with significantly reduced incidence of POCD and inflammation and better neurocognitive function postoperatively in comparison with both saline controls and comparator anaesthetics.

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Dataset Information

Early Postoperative Cognitive Dysfunction in Women Undergoing Elective and Emergent Caesarian Section under General Anaesthesia: A Comparative Study.

Background

Objectives

Methods

Results

Conclusions

Publications

Early Postoperative Cognitive Dysfunction in Women Undergoing Elective and Emergent Caesarian Section under General Anaesthesia: A Comparative Study.

Similar Datasets

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