Postoperative delirium is an acute mental syndrome that is caused by diffuse cerebral
dysfunction resulting from the action of predisposing and precipitating factors acting
together. It is associated with an increase in mortality and postoperative morbidity and
prolongs the period of hospitalization of the patient Videolaparoscopic surgery has been
increasingly used as a therapeutic and diagnostic method. In order to have a good
visualization of the anatomical structures on which it will act, it is necessary to introduce
gas into the cavity, a mandatory component known as pneumoperitoneum. This technique gives
special characteristics for the conduction of anesthesia, since the positive intra-abdominal
pressure results in changes in the patient’s physiology. Some types of laparoscopic surgery
require the position of Trendelenburg for better visualization of the operative field. Among
the changes related to this position are the increase in cardiac output and intracranial
pressure.

In order to optimize the anesthetic procedure, anesthetic blocks have been increasingly used,
especially the spinal. The association of general anesthesia with spinal anesthesia, followed
by its contraindications is advantageous, because lower doses of anesthetic agents are
necessary for the maintenance of general anesthesia. This association results in an earlier
awakening, a reduction of nausea / vomiting, postoperative pain, length of hospital stay,
cost effectiveness and greater patient satisfaction. As a disadvantage, by associating
general anesthesia with spinal anesthesia, patients become susceptible to the adverse events
of spinal anesthesia. Among these, the most common are headache, hypotension, nausea and
vomiting, pruritus, urinary retention and tremor. Performing spinal anesthesia with opioids
alone, without the use of local anesthetic is also possible, with morphine being the most
used. The benefit of this variation of technique is analgesia for a period of 12 to 24 hours,
without the cardiovascular consequences resulting from the action of the local anesthetic.

JUSTIFICATION: There are no studies in the literature evaluating The objective of this study
is to analyze if the anesthetic techniques employed, general anesthesia or general anesthesia
associated with subarachnoid block, for videolaparoscopic oncologic surgeries, in
Trendelenburg position, differ in relation to the incidence of delirium in the postoperative
period.