Post Operative Cognitive Dysfunction After Breast Surgery

Study Overview
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Brief Summary
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Aim of this trial is to define if Post-Operative Cognitive Dysfunction, detected analyzing changes between pre-operative and post-operative Neurocognitive Test, relate to concentration of effector's site concentration of propofol and remifentanil TCI and to the common intraoperative neuromonitoring values.

Detailed Description
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Post-Operative Cognitive Dysfunction has not been yet investigated after general anaesthesia with Targeted-Controlled-Infusion (TCI) and Laryngeal-Mask-Airway (LMA), daily used in the investigator's Hospital to anesthetize women undergoing breast surgery. Aim of this trial is to define if neurocognitive tests (Montreal Cognitive Assessment, Trail Making Test A and B, Digit Span Test) before and after surgery relate to concentrations at effector's site (Ec) of propofol and remifentanil TCI and the values of Bispectral Index and Entropy monitoring and Surgical Plethysmographic Index (SPI).

Official Title
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Post-Operative Cognitive Dysfunction After Breast Surgery: Incidence and Relation With Common Intraoperative Neuromonitoring Data and Concentration of Propofol and Remifentanil Infused With Targeted Controlled Infusion (TCI )in Women With Laryngeal Mask Airway

Conditions
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Emergence Delirium, Post-Operative Cognitive Dysfunction

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: General Anaesthesia delivered with Propofol and Remifentanil with Targeted Controlled Infusion Use of Laryngeal Mask airway Exclusion Criteria: Neurological pathologies Haemodynamical instability during surgery

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of Post-Operative Cognitive Dysfunction in breast-surgery patients detected with Montreal Cognitive Assessment test | Discover incidence of Post-Operative Cognitive decline analyzing changes in Post-Operative Cognitive Dysfunction changes between Pre-operative Montreal Cognitive Assessment test score and post-operative Montreal Cognitive Assessment test score | Patients will be subjected to Montreael Cognitive Assessment (MOCA) test one day before surgery and 1 day after surgery. This test has a score ranging from 1 (minimum) to 30 (maximum). Better neurocognitve outcome with higher scores) | 
| Incidence of Post-Operative Cognitive Dysfunction in breast-surgery patients detected with Trail Making Test A and B | Discover Post-Operative Cognitive Dysfunction analyzing changes between Pre-operative Trail Making Test A and B test score and post-operative Trail Making Test A and B test score | Patients will be subjected to Trail Making Test (TMT) A and B one day before surgery and 1day after surgery. These tests will be evaluated in seconds required to be completed (better neurocognitive outcome with fewer seconds required) | 
| Incidence of Post-Operative Cognitive Dysfunction in breast-surgery patients detected with Digit Span Test | Discover Post-Operative Cognitive Dysfunction analyzing changes between Pre-operative Digit Span Test score and post-operative Digit Span Test test score | Patients will be subjected to DST one day before surgery and 1 day after surgery. Better neurocognitve outcome with higher scores | 
| Incidence of Post-Operative Delirium in breast-surgery patients | Discover Post-Operative Delirium submitting patients Confusion Assessment Method (CAM-ICU) test | Patients will be subjected to CAM-ICU 15 minutes after awakening from anaesthesia. This test can be positive (Delirium present) or negative (Delirium absent) | 
| Incidence of Post-Operative Cognitive Dysfunction in breast-surgery patients | Discover Post-Operative Cognitive Dysfunction analyzing changes between Pre-operative Short Portable Mental Status Questionnaire score and post-operative Short Portable Mental Status Questionnaire test score | Patients will be subjected to Short Portable Mental Status Questionnaire one day before surgery and 1 day after surgery. Better neurocognitve outcome with lower scores | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Infusion pumps, Intraoperative brain monitoring