بررسي اثر بيهوشي عمومي ونخاعي بر حافظه دور-نزديك

Effect of General and Spinal Anesthesia on Remote -Recent Memory

Objective: Evaluation of memory changes after surgery. Materials and Methods: We designed a clinical anesthesia trial to evaluate the effect of general or spinal anesthesia on remote and recent memory. Patients which were under operation of lower extremity or lower abdominal surgery were randomly assigned to receive either general (32 Patients) or spinal anesthesia (32 Patients). Mean age of patients was 22 ± 2 and ASA Class was I or II. Using revised Wechsler memory scales, the patients were evaluated before surgery and again 24 hours and 3 months later. The regimen of general anesthesia was oral Diazepam (10 mg) at night before operation and midazolam (1 mg) plus fentanyl (2 pg/kg) as premedication and nesdonal (5 mg/kg ) plus Atracurium (0.5 mg/kg) for induction of anesthesia. N2O 50% and Halothane were used for maintenance of anesthesia. Regimen of spinal anesthesia was oral Diazepam I 0 mg at night before surgery and Midazolam(1 mg) as premedication. Spinal anesthesia was done with either Lidocain 100mg or Bupivacain 12 mg. The patients that had high spinal Ievel anesthesia, severe hemodynamic instability or other events which affect on memory were excluded. Results. Analysis of data revealed significant decreases in memory quotient (p<0.00I) , recent memory quotient (p<0.001), verbal index(p<0.00 I) and attention 1 concentration index (p<0.001) in general anesthesia group at first 24h after operation .but no decrease was detected in spinal anesthesia group and no changes was detected in two groups 3 months later and p value in quotient memory, recent quotient memory, verbal index and attention/concentration index was p=0.094 , p=0.171 , p=0. 20, p-0.067 respectivly . Remote memory in both groups was intact 24h and 3 month later. Conclusion: These findings suggest that, in patients receiving GA, at least 24 hours should rest after operation before working or driving.