Assessment of recovery following day-case arthroscopy. A comparison between propofol and isoflurane-based anaesthesia

Fifty healthy patients, aged 15-45 years, undergoing day-case arthroscopy, participated in a study to assess aspects of recovery and mood. Psychomotor tests, including the p-deletion test and the Trieger dot test, were performed pre-operatively and mood was measured using the mood adjective checklist. Anaesthesia in all patients was induced with propofol and a laryngeal mask airway was inserted immediately. All patients received alfentanil as the intra-operative analgesic. The patients were randomly allocated to receive one of two different regimens for maintenance of anaesthesia: propofol group--maintenance with an infusion of propofol 10 mg.kg-1.h-1 for 15 min followed by 6 mg.kg-1.h-1 and nitrous oxide and oxygen (bolus doses of propofol were given if anaesthesia was deemed to be light); isoflurane group--maintenance with isoflurane (inspired concentration 0.5-2.0%) in nitrous oxide and oxygen. Postoperatively, psychomotor tests were repeated every 30 min and mood was measured after 2 h and 24 h. Psychomotor recovery was quicker in the isoflurane group than the propofol group and had returned to baseline values in the isoflurane group by 60 min. The time to discharge was similar in both groups as was the incidence of side effects. There was no difference in mood scores between the groups either at the time of discharge or at 24 h. We conclude that psychomotor recovery is somewhat quicker when isoflurane-based anaesthesia is used for day-case arthroscopy, but other factors, including time to awakening, mood and time to discharge are similar for both techniques.