MoCA test and general anesthesia for a two different surgical techniques

: Introduction Postoperative cognitive dysfunction (POCD) is de fi ned as a new cognitive impairment shown after operation. Many factors may contribute to POCD and has potentially two di ff erent patterns: acute cognitive dysfunction, known as postoperative delirium and a later onset and more persistent POCD. Th e reported incidence vary depending on the group of patients studied, the test used, the time of testing and the choice of control group. POCD can only be diagnosed and measured using tests both pre-and postoperative. In our research we use Montreal Cognitive Assessment (MoCA) test. It is a widely used screening assessment for detecting cognitive impairment. Materials and Methods Th e prospective study included 30 patients who were treated at the University Hospital Centre Zagreb. Th ey were anaesthetized for radical prostatectomy using the TIVA technique and divided into two groups: 19 patients who underwent classical surgery and 11 patients who underwent laparoscopic surgery. Th e MoCA test was analysed pre-operatively and 48 hours after surgery. Parametric tests were not used due to deviations of individual distributions from normal, as determined by Shapiro-Wilk tests (p <, 05) and due to the small number of participants. Precise p-values were calculated, except for the Spearman correlation coe ffi cient, which does not use them. Two-way tests and an alpha value of 5% were used. Results Patients who underwent laparoscopic prostatectomy did not have statistically signi fi cantly di ff erent MoCA test results before surgery than those who underwent classical prostatectomy (U = 59.9, z = 1.96, p = .052). After the operation, patients undergoing laparoscopic prostatectomy achieved statistically signi fi cantly higher results (U = 46.0, z = 2.54, p = .011), with a moderate e ff ect (r = .463). Th e results of the MoCA test were statistically signi fi cantly higher after surgery than before surgery (W = 346.5, z = -3.81, p <.001; not in the table), with a strong e ff ect size (r = .696). Th e amount of improvement in MoCA test results was not statistically signi fi cantly di ff erent for laparoscopic and classical prostatectomy (U = 78.0, z = 1.16, p = .268). Conclusion Postoperative values of the MoCA test are higher than the preoperative in both groups-laparoscopic and classical prostatectomy. Th e results of the research can be explained by the fact that anxiety and concern about the upcoming operation a ff ect the results of the examination pre-operatively. Other observed parameters did not a ff ect the MoCA test results.