Psychometric testing and postoperative evaluation
Anxiety, NPS, anxiety, Pain, Postoperative pain, POCD, pain, depression, Depression
Baseline cognitive status was determined using cognitive testing one day before the surgery. Additionally, severe preoperative anxiety and depression was detected using the Hospital Anxiety and Depression Scale (HADS) (≥11 points were considered abnormal). The tests were performed prior to any sedative premedication in a separate quiet hospital room. Assessment was done by the same team of two trained investigators. Both baseline and postoperative cognitive evaluations for a separate participant was done by the same investigator.The cognitive tasks involved three domains: memory, attention, and logical reasoning. A 10‐item test battery consisted of Auditory Verbal Learning (memory), Odd One Out (logical reasoning), Sequence of Numbers (logical reasoning), Digit Span (memory), Backwards Spelling (attention), Math Processing (logical reasoning), Trail‐Making Test A and B (attention), Cross‐Out Paper and Pencil (attention), and 1‐Back Tests (attention). The total maximum score was 135 points, with each of the 3 categories worth 45 points. The patients were retested 24 h postoperatively with the same modified set of tests. Primary outcome was defined as a magnitude of change in cognitive testing results (total and in separate cognitive domains) from baseline 24 h after the surgery in both study groups. Secondary outcome was incidence of POCD 24 h postoperatively. POCD was defined as more than 20% decrease from the total baseline score.Postoperative pain score was based on 0 to 10 points Numerical Pain Scale (NPS) (0—no pain, 10—worst pain imaginable). Satisfaction after the surgery was assessed using a Likert‐type scale (1—not at all satisfied, 5—extremely satisfied).