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[Evaluation of cognitive functions after anesthesia with propofol]
J Sanou1, D Ilboudo, G Goodall
1Department d'anesthésie-réanimation I, hôpital Pellegrin, Bordeaux, France.
Objectives:
To assess the disturbances and delay of recovery of cognitive functions following propofol anaesthesia, and to evaluate a series of simple cognitive recovery tests.
Study Design:
Prospective comparative non randomized clinical study.
Patients:
Two groups of non premedicated patients, of ASA physical class 1 and 2 were studied. The control group (n = 11) included patients undergoing gastric fibroscopy under local anaesthesia. The propofol group (n = 22) consisted of patients scheduled for coloscopy under propofol anaesthesia.
Methods:
The gastric fibroscopy was performed under local anaesthesia with lidocaine and the coloscopy under general anaesthesia with propofol as the sole anaesthetic. Five cognitive tests, designed to assess short-term memory, delayed memory, the ability to plan complex tasks, attention, and language comprehension were conducted the day before, and 1 hour, 3 hours and 6 hours after the endoscopy.
Results:
The cognitive functions remained significantly depressed for at least 3 hours after anaesthesia, and recovered fully about 6 hours after the cessation of propofol administration. The capacity for planning was the most heavily affected.
Conclusions:
Complete recovery can be evaluated by simple cognitive tests, which showed that cognitive functions are impaired over a longer period than psychomotor functions. Oral instructions may therefore not be fully understood by the patient within 3 hours after anaesthesia, emphasizing the importance of written instructions and the essential role played by a well-informed accompanying person.