Clinical Research Directory

Inclusion Criteria: * Patients aged 18-75 years * American Society of Anesthesiologists (ASA) Physical Status Classification System I-III * Patients scheduled for lobectomy or segmentectomy via Video-Assisted Thoracic Surgery (VATS ) with one-lung ventilation * New York Heart Association (NYHA) class I-II * Patients who have been informed about the study and have provided written informed consent will be included. Exclusion Criteria: * Patients younger than 18 years or older than 75 years * History of alcohol or substance abuse * Patients with chronic NSAID use and/or NSAID use within the last 30 days, or NSAID allergy * Allergy to other drugs used in the study (e.g., bupivacaine) * ASA Physical Status IV-V * Severe hearing, visual, or speech impairment * Dementia, Alzheimer's disease, or psychiatric disorders (psychosis, bipolar disorder, schizophrenia) * History of previous head trauma * Chronic liver disease * Pregnancy * History of cerebrovascular disease * Moderate-to-severe chronic obstructive pulmonary disease (COPD) (predicted FEV₁ \<50%) * GFR \<60 mL/min/1.73 m² * Patients who do not provide written informed consent * Conditions that may cause inaccurate cerebral oximetry readings (subdural and/or extracranial hematoma, intracranial arteriovenous shunts, hyperbilirubinemia) * Patients undergoing emergency surgery * Patients in whom surgery is initiated as thoracotomy or converted to thoracotomy * Patients unable to complete the preoperative MMSE (total score ≤24) will be excluded.