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Psychomotor dysfunction after remifentanil/propofol anaesthesia

Published online by Cambridge University Press:  01 April 2007

I. Dressler ,
T. Fritzsche ,
K. Cortina ,
F. Pragst ,
C. Spies  and
I. Rundshagen
I. Dressler
Affiliation:
University Hospital Charité, Department of Anaesthesiology, Berlin, Germany
T. Fritzsche
Affiliation:
University Hospital Charité, Department of Anaesthesiology, Berlin, Germany
K. Cortina
Affiliation:
University of Michigan, Department of Psychology, Ann Arbor, MI, USA
F. Pragst
Affiliation:
University Hospital Charité, Department of Legal Medicine, Berlin, Germany
C. Spies
Affiliation:
University Hospital Charité, Department of Anaesthesiology, Berlin, Germany
I. Rundshagen
Affiliation:
University Hospital Charité, Department of Anaesthesiology, Berlin, Germany
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Summary

Background and objectives

Early recovery after anaesthesia is gaining importance in fast track management. The aim of this study was to quantify psychomotor recovery within the first 24 h after propofol/remifentanil anaesthesia using the Short Performance Test (Syndrom Kurztest (SKT)), consisting of nine subtests. The hypothesis was that psychomotor performance remains reduced 24 h after anaesthesia.

Methods

Thirty-seven patients scheduled for elective surgery took part in the study. The SKT was performed on the day before general anaesthesia (T0), 10, 30, 90 min and 24 h after extubation (T1). Parallel versions were used to minimize learning effects. Anaesthesia was introduced and maintained with remifentanil/propofol as a target controlled infusion. Propofol plasma concentration was measured 10 and 90 min after extubation. Perioperative pain management included novaminsulfon and piritramide.

Results

Up till 90 min after surgery and anaesthesia, psychomotor performances were significantly reduced as the lower test results in all SKT subtests indicated (P ⩽ 0.007 vs. baseline T0). In the three memory subtests (ST 2, ST 8 and ST 9), psychomotor performance was still reduced on the first postoperative day (P ⩽ 0.005; T1 vs. T0). There was no correlation between propofol plasma concentration and the psychometric test results.

Conclusions

Propofol/remifentanil-based target controlled general anaesthesia for surgery is associated with a reduced psychomotor function up to the first postoperative day. Further studies are needed to confirm the usefulness of the SKT in the perioperative period and to clarify which components in the perioperative period are responsible for a lower performance in the SKT.

Keywords

POSTOPERATIVE PERIODANAESTHESIA RECOVERY PERIOD, cognitive functionPSYCHOMETRICS, short performance testANAESTHESIA GENERALPROPOFOLREMIFENTANIL
Type
Research Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 4 , April 2007 , pp. 347 - 354
Copyright
Copyright © European Society of Anaesthesiology 2006

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