الفهرس 
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Abstract
Postoperative cognitive dysfunction is characterized by impaired recent memory, concentration, language comprehension, and social integration. Postoperative cognitive dysfunction is detected by administration of a neuropsychological test battery. A large variability has been associated with neuropsychological testing and differences in the number and type of neuropsychological tests used. Patients with postoperative cognitive dysfunction may experience delayed transfer from the intensive care unit after surgery, prolonged hospitalization, and a longer recovery before returning to work. Those patients may also experience impaired self-care, increased dependency, increased attrition from rehabilitation, and higher rates of hospital readmission. The mechanisms responsible for postoperative cognitive dysfunction after surgery are not well established, but advanced age, a low educational level, preexisting cognitive impairment, alcohol abuse, and severity of coexisting illness have been proposed as major risk factors. This work was designed to detect the effect of ketamine on postoperative cognitive dysfunction on elderly patients undergoing orthopedic surgery under spinal anesthesia. A total of 42 patients who were scheduled for orthopedic surgeries under spinal anesthesia were eligible for the study. Patients was randomly assigned to either study group where ketamine was administered at a dose of 0.3 mg/kg in a normal saline at 0.9% (250 mL) or control group who were received only normal saline at 0.9%, with the same. To assess postoperative cognitive dysfunction in the studied patients, we measured short portable mental status questionnaire before surgery and two hours after surgery. Bothe groups had comparable baseline data. The main finding of the current study was that there was no significant difference between both studied groups as regard mean change in short portable mental status questionnaire (-0.14 ±1.16 vs. 0.09 ± 0.59; p= 0.065) In conclusion, the incidence of postoperative cognitive dysfunction was not significantly influenced by a bolus dose of ketamine after orthopedic surgery in elderly patients. But future studies on large number of patients in multiple centers with longer duration of follow for the cognitive function are warranted.