The Effect of Steep Trendelenburg Position on Neurocognitive Functions in Robotic Radical Prostatectomy Cases

Examining the Effect of Steep Trendelenburg Position on Neurocognitive Functions With MoCA Test in Robotic-assisted Radical Prostatectomy Surgeries.

The aim of this study is to evaluate the effects of the steep Trendelenburg position in robotic prostatectomy cases, where anesthesia depth is monitored using BIS and cerebral perfusion is tracked with NIRS, and to determine the incidence of neurocognitive dysfunction using the MoCA test in the postoperative period.

Steep Trendelenburg position and CO₂ pneumoperitoneum during robotic radical prostatectomy lead to significant changes in intracranial pressure and cerebral oxygenation, which may contribute to postoperative neurocognitive dysfunction (POCD). Monitoring anesthesia depth with Bispectral Index (BIS) and cerebral perfusion with Near-Infrared Spectroscopy (NIRS) may help detect early neurocognitive changes, and MoCA test assessments will reveal a measurable decline in cognitive function postoperatively.

Inclusion Criteria:

• Age ≥ 65 years
• ASA II-III risk score
• Patients scheduled for robotic radical prostatectomy
• Patients who voluntarily agree to participate

Exclusion Criteria:

• Age < 65 years
• History of neurological or psychiatric disorders
• Inability to undergo robotic surgery
• Conversion to open prostatectomy during surgery
• Patients who do not consent to participate