Cognitive recovery after ambulatory anaesthesia based on desflurane or propofol: a prospective randomised study

The impact of anaesthetic agents on cognitive recovery during the first post-operative week in a middle-aged population undergoing general anaesthesia is insufficiently studied. We hypothesised that patients receiving anaesthesia based on desflurane would have a quicker recovery and regain cognitive capacity faster than patients receiving anaesthesia based on propofol.

We performed a prospective, randomised, single-blinded study comparing the effects of desflurane and propofol as primary anaesthetic agents on cognitive recovery in 59 American Society of Anesthesiologists Physical Status Classification System I-II women undergoing breast surgery. Cognitive recovery was evaluated using the Cognitive Failure Questionnaire and a modified version of the Post-operative Quality of Recovery Scale.

Post-operative cognitive recovery according to Cognitive Failure Questionnaire was 65% and 66% at 72 h, and 71% and 72% at 1 week for the desflurane and the propofol groups, respectively. Recovery according to Post-operative Quality of Recovery Scale was 52% and 50% at 2 h, increasing to 71% and 87% at 48 h for the desflurane and the propofol groups, respectively. At the final point of measurement (Cognitive Failure Questionnaire 1 week, Post-operative Quality of Recovery Scale 48 h), many of the patients had still not reached their baseline cognitive performance. There was no difference in overall cognitive recovery between the desflurane and propofol groups.

Cognitive recovery was not complete 1 week after surgery in any of the groups. There was no difference in the rate of cognitive recovery in middle-aged patients receiving desflurane or propofol anaesthesia during ambulatory breast surgery.