Özgür Emre POLAT, Veysel ERDEN
İstanbul Medical Journal - 2026;27(1):1-6
Introduction: This research investigates the impact of general anesthesia (GA) and spinal anesthesia (SA) on cognitive function following extremity surgery. Methods: A prospective cohort study was conducted with 60 patients (30 GA, 30 SA) undergoing elective extremity surgery. Cognitive function was assessed preoperatively and at 4 and 24 hours postoperatively using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Results: At 4 hours postoperatively, MoCA scores were significantly higher in the SA group (21.6+/-2.6) compared to the GA group (20.8+/-4.4; p<0.001). By 24 hours, cognitive recovery was more pronounced in the SA group (22.7+/-2.8) than in the GA group (22.0+/-4.2) (p=0.001). MMSE scores followed a similar trend: at 24 hours, SA patients had a significantly higher score (26.1+/-2.3) than GA patients (25.6+/-3.0; p=0.044). The cognitive improvement over 24 hours was more substantial in SA patients (MMSE: 2.1+/-0.9; MoCA: 2.2+/-1.4) than in GA patients (MMSE: 0.67+/-1.4; MoCA: 0.67+/-1.8), both p<0.001. Age-based analysis showed that patients under 40 years of age had higher baseline cognitive scores and greater postoperative improvement, regardless of anesthesia type (p<0.001). Conclusion: Compared with GA, SA was associated with a faster and more pronounced postoperative recovery of cognitive function. These findings suggest that SA may be preferable for reducing early cognitive impairment, particularly among older patients. Long-term follow-up is needed to confirm these effects.
