The Impact of Anesthesia Method on Postoperative Cognitive Functions in Urological Surgeries: A Prospective Randomized Single-Blind Study

Abstract

Introduction: Postoperative cognitive dysfunction contributes to cognitive impairments after surgery. Despite the potential of anesthesia methods causing cognitive dysfunction, conclusive evidence remains elusive. This study aims to compare the effects of general and spinal anesthesia on postoperative cognitive functions in patients undergoing urological surgeries. Materials and Methods: A total of 108 patients aged from 18 to 75 years, who underwent elective surgery with ASA I-II-III (American Society of Anesthesiology) risk classification, were included in this study. Regardless of the anesthesia method chosen for surgery, the Mini-Mental State Test (MMST) was administered by a clinician at 24 hours preoperatively to assess cognitive functions in a blinded manner. At postoperative 24 hours, the same independent clinician repeated the MMST assessment. Preoperative and postoperative MMST scores were recorded. Patients were categorized into two groups: Group G received general anesthesia, and Group S underwent spinal anesthesia. Demographic data, surgery durations, and MMST values of the cases were compared between groups. Results: Of the 108 included patients, 80 were male (74.1%) and 28 were female (25.9%). Forty-eight patients received general anesthesia (Group G), while 60 patients received spinal anesthesia (Group S). No significant differences were observed between the groups in terms of age, ASA classification, and comorbidities. The female-to-male ratio was statistically significantly higher in Group G, while the male-to-female ratio was higher in Group S. The average surgery duration in Group G (87.56 ± 28.15 minutes) was significantly longer than that in Group S (61 ± 18.91 minutes). When comparing preoperative and postoperative 24-hour MMST scores in both groups, no statistically significant differences were observed. Conclusion: This study showed that either general or spinal anesthesia showed no affect on postoperative cognitive dysfunction among patiens underwent urological surgery. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.