Cognitive Disorders of Geriatric Patients in Urological Operations

The prospective cohort study consisted of two groups of patients: 1) surgery under spinal anesthesia without sedation; 2) surgery under spinal anesthesia with propofol sedation. To register cognitive status and depressive symptom complex, the Brief Mental Status Assessment Scale (MMSE test) and the Hamilton Depression Scale were used. Patients in both study groups (more than 50%) experienced mild depressive disorder and mild cognitive impairment befor surgery. The main factors of the depressive symptom complex in patients of both groups: sexual disorders (87%), early insomnia (81%), moderate insomnia (77%), working capacity and activity (77%), mental anxiety (74%), somatic anxiety (52%). The use of sedation with propofol under the control of BIS-monitoring in the intraoperative period in patients of gerontological age with BTUR using regional anesthesia did not significantly affect on the cognitive status (MMSE test), and reduces the severity of the depressive symptom complex according to the mental status scales (Hamilton Depression Scale) in postoperative period. On the second postoperative day, the results on the Hamilton Depression Scale in the group with sedation showed decrease from
$8.6\pm 1.4$
(baseline) to
$7.2\pm 1.1(p < 0.0 5)$
. Three parameters of the Hamilton Depression Scale determined a significant decrease in the total score in the study group with sedation:average insomnia (58%), working capacity and activity (55%), mental anxiety (55%)