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Psychotherapy as a means of prevention and correction of possible cognitive decline when using general anesthesia. Actuality: cognitive decline when using anesthesia is a possible complication of its application that underlines the importance of study of the measures aimed at preventing or reducing negative consequences. Abstract Cognitive deficits can lead to significant functional disorders, decreased intellectual function, attention deficits, memory decline, changes in personality and behaviour, mood disorder, violation of physical and social function, at severe stages to dementia and daily necessity in the people providing care to these patients. Hypothesis: psychotherapy as a means of prevention and correction of possible cognitive decline when using anesthesia. Objective: to assess the incidence of cognitive decline of patients of spinal neurosurgical department during the surgical treatment and anesthetic propofol and fentanyl application. To consider possible ways of its prevention and correction using psychotherapy. Methods MoCA, FAB, Schulte tables, HADS, Spielberger-Hanin anxiety test, Wechsler Memory Scale, Pain Detect, projective drawing method (Art -testing). The methods of descriptive statistics, hypothesis testing by Mann–Whitney U test. Results In the study 66 patients (43 women, 23 men) of the spinal neurosurgical department with chronic back pain. Patients were randomly divided into two equal groups of 33 persons each. Group A (average age 50.25) had sessions with a psychologist in cognitive-behavioral psychotherapy aimed at decreasing levels of anxiety and depression before surgery and every day since the next day after surgery. Group B (average age 49.03) did not have such activities. All patients were tested by a psychologist using scales before surgery and on the sixth day after it. Anesthesia duration was in average 4 hour. Conclusions Cognitive assessment of Group B shows significant cognitive decline after anesthesia. While test results of Group A in which daily classes in psychotherapy with a psychologist were conducted did not show significant cognitive impairment after anesthesia. Keywords: general anesthesia, cognitive decline, psychotherapy