title: THE IMPACT OF ANESTHETIC TECHNIQUES ON COGNITIVE FUNCTIONS AFTER UROLOGICAL SURGERY.
abstract: BACKGROUND
  Postoperative cognitive dysfunction (POCD) is a well-recognized complication of cardiac and noncardiac surgery. However, contradictory results concerning postoperative mental function have been reported. The aim is to determine the effect of anesthetic techniques (general or spinal) on cognitive functions using more sensitive neuropsychological tests in patients undergoing urological surgery.
  
  
  METHODS
  A total of thirty patients were enrolled in the study and assigned to receive either general (n = 15) or spinal (n = 15) anesthesia. A battery of neuropsychological tests including Wisconsin Card Sorting Test, Iowa Gambling Task, Stroop Color-Word Test, N-back Task and Continuous Performance Test was performed preoperatively and three days later.
  
  
  RESULTS
  The two experimental groups were similar at baseline assessment of cognitive function. Although there were no statistically significant differences between general and spinal anesthetic groups with respect to Wisconsin Card Sorting Test and Iowa Gambling Task, a significant intergroup difference between pre-and postoperative N-back scores was detected in the general anesthesia group (p = 0.001 & p = 0.004). In addition, patients within this group had significantly higher error rates on the Stroop Color-Word (p = 0.019) and Continuous Performance Tests (p = 0.045). In contrast, patients receiving spinal anesthesia exhibited little change or marginal improvement on all subscales of the battery.
  
  
  CONCLUSIONS
  Our findings indicate significant decline in specific aspects of mental function among patients who were administered general anesthesia compared with the other technique. It seems that spinal anesthesia contributes to lower disturbance after surgery.
authors.forename: Mahtab Poor Zamany Nejat
authors.initials: MP
authors.lastname: Kermany
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Soltani
authors.forename: Khazar
authors.initials: K
authors.lastname: Ahmadi
authors.forename: Hoora
authors.initials: H
authors.lastname: Motiee
authors.forename: Shermin
authors.initials: S
authors.lastname: Rubenzadeh
authors.forename: Vahid
authors.initials: V
authors.lastname: Nejati
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000775:Anesthesia, Spinal; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013520:Urologic Surgical Procedures / Q000009:adverse effects*