REDUCTION IN THE INCIDENCE OF POSTOPERATIVE COGNITIVE IMPAIRMENT AFTER CESAREAN SECTION DURING SPINAL ANESTHESIA WITH KVANADEX
Keywords:
Postoperative cognitive dysfunction; cesarean section; spinal anesthesia; dexmedetomidine; sedation; cognitive function; obstetric anesthesia.Abstract
Postoperative cognitive dysfunction (POCD) is a common complication following surgical interventions and anesthesia, particularly in obstetric practice. This study aimed to reduce the incidence of POCD after cesarean section by optimizing anesthetic management during spinal anesthesia. A prospective clinical study was conducted from 2022 to 2023 at the multidisciplinary clinic of Samarkand State Medical University, involving 38 pregnant women at 37–40 weeks of gestation scheduled for elective cesarean section. All patients were classified as ASA II and were divided into two groups. In the first group, intravenous sedation was performed using sodium oxybutyrate (40 mg/kg), while in the second group dexmedetomidine (Kvanadex) was administered at a loading dose of 0.5–0.8 μg/kg followed by continuous infusion throughout the operation. Cognitive functions were assessed using the Mini-Mental State Examination (MMSE), and sedation depth was monitored with the Richmond Agitation-Sedation Scale (RASS).The results demonstrated that spinal anesthesia was effective in all patients, providing adequate sensory and motor blockade. The use of dexmedetomidine was associated with greater hemodynamic stability, absence of respiratory depression, lower stress hormone levels, and a significantly reduced incidence of early postoperative cognitive impairment compared to sodium oxybutyrate. MMSE scores in the dexmedetomidine group recovered more rapidly in the postoperative period.In conclusion, intraoperative sedation with dexmedetomidine during spinal anesthesia for cesarean section is a safe and effective strategy that improves hemodynamic stability and significantly reduces the risk of postoperative cognitive dysfunction, contributing to faster recovery and better postoperative outcomes.
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