Original scientific paper
https://doi.org/10.21857/m16wjcnkx9
MoCA test and general anesthesia for a two different surgical techniques
Marijana Žura
Tea Pašalić
Vida Demarin
Andreja Kulić
Zrinka Orešković
Ivana Vukušić
Slobodan Mihaljević
Sandra Morović
Abstract
Introduction Postoperative cognitive dysfunction (POCD) is defined as a new cognitive impairment shown after operation. Many factors may contribute to POCD and has potentially two different patterns: acute cognitive dysfunction, known as postoperative delirium and a later onset and more per- sistent POCD. The 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 The prospective study included 30 patients who were treated at the University Hospital Centre Zagreb. They 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. The 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 coefficient, 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 significantly different MoCA test results before surgery than those who underwent classical prostatec- tomy (U = 59.9, z = 1.96, p = .052). After the operation, patients undergoing laparoscopic prostatec- tomy achieved statistically significantly higher results (U = 46.0, z = 2.54, p = .011), with a moderate effect (r = .463). The results of the MoCA test were statistically significantly higher after surgery than before surgery (W = 346.5, z = -3.81, p <.001; not in the table), with a strong effect size (r = .696). The amount of improvement in MoCA test results was not statistically significantly different for lapa- roscopic 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 prosta- tectomy. The results of the research can be explained by the fact that anxiety and concern about the upcoming operation affect the results of the examination pre-operatively. Other observed parameters did not affect the MoCA test results.
Keywords
Hrčak ID:
290805
URI
Publication date:
18.12.2022.
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