Menstrual Cycle Phases on Recovery and Cognitive Function
Condition: Menstrual Cycle; Cognitive Function; Recovery; General Anesthesia
Study type: Observational

Summary: 
      The aim of this study was to investigate the effects of menstrual cycle phases on recovery
      and cognitive function after general anesthesia.
    

Detailed description: 
      Study Protocol, Methods and Procedures to be Applied:

      The study was started after obtaining the approval of the Ethics Committee, the written
      approvals of the patients The study is planned to conduct between October 2018- December
      2018.

      The study groups were selected from patients who presented to the preop anesthesia polyclinic
      in elective conditions, septo-rinoplasty operation under general anesthesia.

      The study groups will be selected from patients who presented to the preop anesthesia
      polyclinic in elective conditions, septo-rinoplasty operation under general anesthesia.
      Assuming that there would be a 5-point difference in anxiety scores among the groups, it was
      decided to take 45 cases for each group with a 0.75 standard effect size, 80% power, and 5%
      error. Patients will be randomly assigned to 2 groups of 45 people according to their order
      of application. Patients will be randomized by inclusion into the determined groups. At the
      day of surgery, the inclusion of the patient into the one of the group will be decided.

      Study inclusion criteria: The study included 80 women with ASA I-II, aged 18 to 45 years, who
      were accepted to participate in the study, were smoking, did not use oral contraceptives, had
      no menstrual irregularity (regular 28 ± 2 days menstrual cycle).

      Study exclusion criteria: In preop evaluation patients had difficulties in communication,
      amenorrhea, pregnancy, delirium, psychological illness, major depressive disorder, patients
      with a history of acute illness (such as in intensive care unit follow-up), which may affect
      cognitive function and daily life activities in the last 6 months, malignancy, acute renal
      failure, substance abuse and patients older than 45 years and male sex will be excluded from
      the study.

      Groups:

      Information about menstrual cycle patterns was obtained from all cases. The days of the
      menstrual cycle will be determined starting from counting the first day of the last cycle.
      Patients with menstrual cycle between 8-12 days were called Group F (Follicular phase).
      Patients with menstrual cycle between 20-24 were called Group L (Luteal phase). The follow-up
      of the cases and the recording of the measurements were performed by an anesthesiologist who
      did not know which group the cases were in.

      Procedures to be Applied:

      Patients' gender, age, height, weight values, ASA scores, body mass index (BMI) values will
      be recorded.

      Preoperative anesthetic examinations of the patients to be included in the study will be done
      at the anesthesia clinic at least 1 day before the operation. The preop tests that will be
      required after the examinations will consist of routine examinations.

      In the operation room, hemodynamic parameters will be recorded at 5-minute intervals before
      induction, after intubation.

      Routine procedures that is applied to similar patients will be followed during extubation of
      patients. The inside of the mouth will be aspirated before extubation and the patient will be
      extubated after muscle strength and consciousness's are restored.

      Total anesthesia duration and total surgical duration, postoperative agitation, laryngospasm,
      hypoxia, nausea and vomiting frequency will be recorded.

      After general anesthesia, the time of return of the behaviors such as opening the eyes,
      fulfilling the orders or saying the age will be recorded and evaluated as the recovery
      criteria. In the postop recovery period, the patient will be subjected to mini mental state
      testing (MMST) and cognitive functions will be evaluated.
    

Intervention name(s): Group F
Intervention type(s): Behavioral
Intervention description(s): After general anesthesia, the time of return of the behaviors such as opening the eyes, fulfilling the orders or saying the age will be recorded and evaluated as the recovery criteria. In the postop recovery period, the patient will be subjected to mini mental state testing (MMST) and cognitive functions will be evaluated.
Other intervention name(s): Group L
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Current study is performed on female gender with reguler menstrual cycle, who were accepted
        to participate in the study,
      
Keywords: General Anesthesia; Recovery; Cognitive Function; Menstrual Cycle phase