EFFECT OF POSTOPERATIVE PAIN AFTER INGUINAL HERNIORRHAPHY ON POSTOPERATIVE COGNITIVE DYSFUNCTION

Introduction: Inguinal herniorrhaphy is one of the most common operations in general surgery, frequently performed under general anesthesia due to a lack of experience with regional anesthesia. General anesthetic affects central nervous system functions to varying degrees and durations, apart from the acute loss of consciousness. This psychomotor function disorder observed after operations are defined as postoperative cognitive dysfunction (POCD). The mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) are the methods most frequently used for POCD assessment. Objective: This study evaluates the correlation between early-period cognitive functions and postoperative pain scores in patients operated for inguinal hernia. Methodology: The study included 100 patients aged 18-70 years, with ASA I-III, undergoing unilateral inguinal herniorrhaphy. Fifty sequential patients with TAP block performed were included in the TABP group (TG), while 50 patients choosing multimodal analgesia were included in the control group (CG). The patients' pain scores were evaluated with VAS, and for POCD evaluation, MMSE was performed before the operation to assess postoperative cognitive dysfunction during the study. The correlation between postoperative visual analog scale (VAS) scores and MMSE was evaluated in both groups. Results: VAS scores at the 15th min, 30th min, 2nd h, 12th h, and 24th h were lower in TG than the CG cases with statistical significance (Table 3, p=0.001; p<0.01). Although the 6th h VAS score of TG cases was lower than those in CG, it was not statistically significant (Table 3, Figure 1, p>0.05). There were no statistically significant differences observed between MMSE scores between the patients in both groups (p>0.05, Table 4). But there were statistically significant differences between the preoperative and postoperative MMSE scores in both groups (p=0.001; p<0.01). Conclusions: POCD and MMSE scores were associated more with the anesthesia method selected in our study of general anesthesia. There was no significant correlation between the postoperative VAS scores and the POCD.