Cognitive Changes in Laparoscopic Cholecystectomy: Cognitive Assessments in Decision-Making Matters

Area of Science:

• Neuroscience
• Anesthesiology
• Cognitive Psychology

Background:

• Postoperative cognitive dysfunction (POCD) can impact patient safety and recovery, even after minor procedures.
• Neuropsychological assessment at discharge is crucial for evaluating readiness for daily activities.
• This study examines cognitive changes following minor surgery under general anesthesia.

Purpose of the Study:

• To investigate postoperative cognitive changes after minor surgery.
• To compare cognitive performance between propofol and sevoflurane anesthesia groups and a non-surgical control group.

Main Methods:

• 105 participants (37 non-surgical, 34 propofol, 34 sevoflurane) underwent laparoscopic cholecystectomy or served as controls.
• Cognitive function was assessed at baseline and discharge using the Computerized Visual Attention Test (CVAT), Controlled Oral Word Association Test (COWAT), and Symbol Digit Modalities Test (SDMT).
• Statistical analysis included multivariate analysis of variance (MANOVA) and analysis of variance (ANOVA) with Bonferroni correction.

Main Results:

• Significant group differences in sustained attention, verbal fluency, and executive function were observed (MANOVA, p < 0.001).
• The propofol group showed decreased sustained attention compared to controls.
• Both surgical groups exhibited poorer verbal fluency than the improved non-surgical group; the sevoflurane group also showed worse performance on executive function tests.

Conclusions:

• Minor surgery under general anesthesia can induce transient cognitive impairments in attention and learning.
• Postoperative cognitive monitoring is recommended to ensure patient safety.
• Individualized discharge decisions based on cognitive status are essential for optimal patient outcomes.