Background: Postoperative cognitive dysfunction (POCD) is a well recognized complication following various operative procedures. The role of anesthetic agent in etiopathogenesis is still controversial. The
present study aims to describe and compare effects of general and regional anesthesia on post-operative cognitive functions among patients undergoing orthopedics surgery. Methods: A total of 80 patients aged 20-60 years, belonging to either sex, scheduled for <120 minutes duration orthopaedic surgery of lower limb, with good physical status, and with ±20% ideal weight were included. Patients unwilling for consent, past anesthetic use, cognitive impairment, sub-normal intelligence, substance use disorder, psychiatric disorder, and chronic medical condition were excluded. Patients were randomized to receive either general anesthesia (n=40) or regional anesthesia (n=40) during surgery. After routine preanesthetic examination and laboratory investigations, Hindi version of mini-mental status examination scale was applied prior to surgery and at 24h, 2weeks, and 6 weeks postoperatively. Results: The prevalence of POCD at 24 h, 2 weeks, and 6 weeks after the surgery was higher among general anesthesia group (80%, 52.5%, and 27.5% respectively) compared with regional anesthesia group (57.5%, 27.5%, and 15% respectively). When compared with regional anesthesia group, the cognitive domains related to orientation to time, place, registration, recall, and copying at 24 h and recall at 2 weeks postoperatively were significantly affected in general anesthesia group. Conclusion: Although POCD has multifactorial etiopathogenesis, the role of general anesthesia cannot be completely
refuted. Besides preoperative and intraoperative precautions, postoperative cognitive remediation techniques may be recommended. Further studies investigating effect of individual anesthetic agent in causing POCD is required.

Keywords: Anesthesia; Postoperative Complications; Cognitive Dysfunction.