Comparison of two methods Mini mental state examination (MMSE) vs Montreal cognitive assessment (MoCA) in diagnosing early postoperative cognitive disorders in elderly patients undergoing elective surgery under general anaesthesia.

This study aims to comprehensively evaluate the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in assessing early postoperative cognitive disorder in elderly patients undergoing elective surgery under general anaesthesia. Patients aged more than 60y scheduled for elective surgery under general anaesthesia will be recruited preoperatively. They will be administered MMSE and MOCA concurrently a day prior to surgery. The tests will be re administered within 48 hours postoperatively. Age, sex, education level, ASA grade, h/o cardiovascular disease and other comorbidities, type of surgery , site of surgery will be noted prior to administering the tests. Anaesthesia will be standardised using intravenous glycopyrrolate 0.01 mg/kg , intravenous propofol 2mg/kg, fentanyl 2mcg/kg and atracurium 0.5 mg/kg . Anaesthesia induction will be followed by endotracheal intubation or LMA insertion. Anaesthesia will be maintained according to the standard protocol of the department. Reversal will be carried out with combination of neostigmine(0.05 mg/kg) and glycopyrrolate(0.01 mg/kg). Surgical time and intraoperative blood loss will be noted during surgery. ) Patients’ preoperative demographic information (sex, age, level of education), comorbidities, preoperative cognitive status and site and type of surgery will be noted, intraoperative data comprising of anaesthesia technique, intraoperative blood loss, time of surgery and any specific episodes of hypotension, blood transfusions, cardiac arrythmias will be noted, Data on postoperative cognitive assessments and any complications will be collected postoperatively