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Neuropsychologic testing within 18 hours after cardiac surgery
B S Silbert1, D A Scott, T J Doyle
1Department of Anaesthesia, St. Vincent's Hospital, Melbourne, Australia.
Objective:
To undertake neuropsychologic testing within 18 hours of cardiac surgery after fast-track anesthesia.
Design:
Prospective study.
Setting:
University hospital, single center.
Participants:
Fifty patients undergoing first-time elective coronary artery surgery.
Interventions:
A neuropsychologic test battery was administered preoperatively and 18 hours and 5 days after surgery.
Main Results:
Seven patients were withdrawn, and 9 patients did not attempt the postoperative tests (on both occasions) because of medical complications. Thirty patients completed > or =4 tests at both postoperative occasions. Of these, 9 patients (30%) showed a deficit in > or =2 tests at 18 hours postoperatively, and 3 (10%) showed a deficit at 5 days postoperatively.
Conclusion:
In the absence of medical complications and despite the difficulties, early postoperative neuropsychologic testing is possible after fast-track anesthesia. Such testing has the potential to more clearly define the course of cognitive decline after cardiac surgery.