Does Positioning Effects on Early Postoperative Cognitive Dysfunction in Laparoscopic Oncological Surgery

In Saglık Bilimleri University, Ankara A.Y. Oncology Research and Trainnee Hospital, Anesthesiology and reanimation clinic,patients who are scheduled for elective laparoscopic major abdominal surgery after the approval of the Ethics Committee will be enrolled in the study. From the beginning of the study, successive patients were included in the study. Measurement values were taken and recorded using the NIRS device in our clinic throughout the case in patients 18 years of age and older. All patients were evaluated with MMSE in preoperative and postoperative period. According to power analysis using mean and standard deviation to determine the sample size of the patients to be taken in this process, at least 52 patients were planned to be included in the study. After preoperative MMSE testing, ASA scores, comorbidities,demographic data, drugs used in anesthesia, vasopressor use, pneumoperitonium pressures and duration, angle and duration of trendelenburg position, and vital parameters were recorded with NIRS device in our clinic. MMSE test was re-administered to all patients in the first week of postoperative period. Patients with preoperative MMSE score (M0) 24/30 points and above; postoperative 7th day (M1) was re-evaluated and those with a fall of 4 points and more in M1 score than M0 score were assessed as POCD. NIRS measurements were taken perioperative and their correlation with POCD was looked at. Inclusion criteria; * 18 years and older, * preoperative 24 points and above on MMSE test(M0) * Laparoscopic major abdominal oncological surgery planned patients who will receive general anesthesia. Exclusion criteria; * People with a history of cerebral ischemia or hemorrhage, * Those with a history of neurodegenerative disease, * Those with diagnosed carotid stenosis, * Those with a score of 23 and below on the MMSE test, * Those with a history of Carotid Endarterectomy, * Patients who have undergone aneurysm surgery, * Those who are addicted to alcohol, * Those with psychiatric illness, * Those who have undergone cervical surgery, * Those with a history of transient ischemic attacks,