Effects Of Different Parities On Early Cognitive Function Of Cesarean Women Under Spinal Anesthesia

Objective:This study intends to explore the effects of different parities on early cognitive changes in postpartum cesarean sections under spinal anesthesia,so as to provide a reference for clinical pregnancy and post-pregnancy women's cognitive function research.Methods:A total of 70 women who underwent elective cesarean section at the Affiliated Hospital of Guilin Medical College from June 2018 to June 2019 were randomly selected.The parity was between 1and 2 times and ASA I to II.Those between the ages of 20 and 40 years without any cognitive function related diseases.According to parity,they were divided into one parity group?group A,n=35 cases?and second parity group?group B,n=35 cases?.35 non-pregnant women aged 20 to 40 years were randomly selected as blank Group?group C,n=35 cases?.All pregnant women in the experimental group were routinely prepared before surgery,connected to ECG monitoring after admission,recorded heart rate?HR?,mean arterial pressure?MAP?,pulse oxygen saturation?SpO₂?,open upper limb vein access,and quickly infused 500ml of polygelatin peptide injection was expanded.The patient was placed in the left lateral position,and a single subarachnoid block was obtained with a straight L₂ to L₃ gap approach.After seeing out of the cerebrospinal fluid,2.3 to 2.5ml of 0.5%ropivacaine hydrochloride injection was injected at 0.1ml/s.All enrolled women were given postoperative intravenously personal controlled analgesia,and changes in HR,MAP,and SpO₂at all time points were recorded at the time of admission?T₀?,initiation of surgery?T₁?,fetal retrieval?T₂?,and completion of surgery?T₃?.The cognitive assessment scale?Montreal Cognitive Assessment,Mo CA?assessed maternal cognitive function on the 1st day before surgery,the 1st day and the 3rd day after the operation.Results:There was no significant difference in the changes of HR,MAP,and SpO₂ at time points T₀,T₁,T₂,and T₃ in groups A and B?P>0.05?.?1?The effects of surgery and anesthesia on cognitive function:there was no significant difference in the Mo CA scale scores of group A?28.05±0.89?,group B?27.88±0.87?and group C?28.03±1.59?the 1st day before the operation?P>0.05?.The Mo CA scale scores of group A and group B at 1st day?group A:26.91±1.46,group B:25.32±1.78?and 3rd?group A:26.82±1.52,group B:25.29±1.83?days after operation were lower than those in group C?28.03±1.59?,and the difference was statistically significant?P<0.05?.Compared with 1st before surgery?group A:28.05±0.89,group B:27.88±0.87?,the Mo CA scale scores in group A and B decreased at 1st day?group A:26.91±1.46,group B:25.32±1.78?and 3rd days?group A:26.82±1.52,group B:25.29±1.83?after surgery,the difference was statistically significant.?P<0.05?.?2?Effect of different parities on postoperative cognitive function:Compared with group A?1st days after surgery:26.91±1.46,3rd days after surgery:26.82±1.52?,the Mo CA scale scores were lower in group B at 1st day?25.32±1.78?and 3rd days?25.29±1.83?after surgery,the difference was statistically significant?P<0.05?.?3?Analysis of early cognitive function changes in cesarean parturients:Compared with group C?1.89±0.32?,the abstraction scores of groups A and B were reduced at 1st day?group A=1.04±0.50,group B=1.01±0.47?and 3rd days after surgery?group A=1.12±0.55,group B=1.07±0.50?,and the differences were statistically significant?P<0.05?;Compared with group C?4.62±0.49?,the delayed recall scores of groups A and B were reduced at 1st day?group A=3.19±0.69,group B=3.05±0.68?and 3rd days after surgery?group A=3.21±0.75,group B=3.17±0.91?,and the differences were statistically significant?P<0.05?.Conclusions:In the early postoperative period of cesarean section,there may be a slight decrease in cognitive function,which is more pronounced in the second-child group than in the first-child group;cognitive impairment early in the postoperative period is mainly reflected in abstraction and delayed recall.