[Specialty of cognitive impairments in geriatric patients in urological practice.]

Purpose of the study - to assess the level of cognitive disorders in gerontological patients of the urological profile, depending on the use of sedation in the intraoperative period. A prospective cohort study was performed on 60 gerontological patients diagnosed with BPH II-III stages. Two groups were formed: conscious patients and patients using sedation. Operation - bipolar transurethral enucleation of the prostate (BTUEP). Determination of the depth of sedation with propofol was carried out according to the Ramsey sedation scale in the BIS-monitoring mode. Registration of cognitive status was carried out on the basis of the Montreal Cognitive Function Scale and the Hamilton Depression Scale. The level of cognitive functions of patients in both study groups before surgical treatment indicated the presence of mild impairments according to the Montreal Cognitive Function Scale and the Hamilton Depression Scale. In the group using sedation in patients, a statistically significant decrease (p<0,005) in the score for three items of the Hamilton depression scale was determined in comparison with the group with preserved consciousness in patients: average insomnia (χ2=5,07), working capacity and activity (χ2=4,17), mental anxiety (χ2=4,43). Anesthesia, including spinal anesthesia and sedation controlled by BIS-monitoring, in gerontological patients during BTUEP provides a positive effect on the cognitive functions of patients and reduces the manifestations of depressive symptoms according to the results of clinical interviews using the Montreal Cognitive Assessment Scale and the Hamilton Depression Scale.