Cognitive status of patients judged fit for discharge from the post-anaesthesia care unit after general anaesthesia : a randomized comparison between desflurane and propofol
BACKGROUND: The Aldrete's score is used to determine when a patient can safely leave the Post-Anaesthesia Care Unit (PACU) and be transferred to the surgical ward. The Aldrete score is based on the evaluation of vital signs and consciousness. Cognitive functions according to the anaesthetic strategy at the time the patient is judged fit for discharge from the PACU (Aldrete's score ≥ 9) have not been previously studied. The aim of this trial was to assess the cognitive status of inpatients emerging either from desflurane or propofol anaesthesia, at the time of PACU discharge (Aldrete score ≥ 9).
METHODS: Sixty adult patients scheduled for hip or knee arthroplasty under general anaesthesia were randomly allocated to receive either desflurane or propofol anaesthesia. Patients were evaluated the day before surgery using Digit Symbol Substitution Test (DSST), Stroop Color Test and Verbal Learning Test. After surgery, the Aldrete score was checked every 5 min until reaching a score ≥ 9. At this time, the same battery of cognitive tests was applied. Each test was evaluated separately. Cognitive status was reported using a combined Z score pooling together the results of all 3 cognitive tests.
RESULTS: Among the 3 tests, only DSST was significantly reduced at Aldrete Score ≥ 9 in the Desflurane group. Combined Z-scores at Aldrete Score ≥ 9 were (in medians [interquartils]): - 0.2 [- 1.2;+ 0.6] and - 0.4 [- 1.1;+ 0.4] for desflurane and propofol groups respectively (P = 0.62). Cognitive dysfunction at Aldrete score ≥ 9 was observed in 3 patients in the Propofol group and in 2 patients in the Desflurane group) (P = 0.93).
CONCLUSION: No difference was observed in cognitive status at Aldrete score ≥ 9 between desflurane and propofol anaesthesia. Although approximately 10% of patients still had cognitive dysfunctions, an Aldrete score ≥ 9 was associated with satisfactory cognitive function recovery in the majority of the patients after lower limb arthroplasty surgery under general anaesthesia.
TRIAL REGISTRATION: Clinical Trials identifier NTC02036736.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
|---|---|
| Enthalten in: |
BMC anesthesiology - 21(2021), 1 vom: 11. März, Seite 76 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Robert, Cyrille [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 07.01.2022 Date Revised 07.01.2022 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1186/s12871-021-01287-9 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM322635969 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM322635969 | ||
| 003 | DE-627 | ||
| 005 | 20231225182448.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s12871-021-01287-9 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1075.xml |
| 035 | |a (DE-627)NLM322635969 | ||
| 035 | |a (NLM)33706698 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Robert, Cyrille |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cognitive status of patients judged fit for discharge from the post-anaesthesia care unit after general anaesthesia |b a randomized comparison between desflurane and propofol |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 07.01.2022 | ||
| 500 | |a Date Revised 07.01.2022 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The Aldrete's score is used to determine when a patient can safely leave the Post-Anaesthesia Care Unit (PACU) and be transferred to the surgical ward. The Aldrete score is based on the evaluation of vital signs and consciousness. Cognitive functions according to the anaesthetic strategy at the time the patient is judged fit for discharge from the PACU (Aldrete's score ≥ 9) have not been previously studied. The aim of this trial was to assess the cognitive status of inpatients emerging either from desflurane or propofol anaesthesia, at the time of PACU discharge (Aldrete score ≥ 9) | ||
| 520 | |a METHODS: Sixty adult patients scheduled for hip or knee arthroplasty under general anaesthesia were randomly allocated to receive either desflurane or propofol anaesthesia. Patients were evaluated the day before surgery using Digit Symbol Substitution Test (DSST), Stroop Color Test and Verbal Learning Test. After surgery, the Aldrete score was checked every 5 min until reaching a score ≥ 9. At this time, the same battery of cognitive tests was applied. Each test was evaluated separately. Cognitive status was reported using a combined Z score pooling together the results of all 3 cognitive tests | ||
| 520 | |a RESULTS: Among the 3 tests, only DSST was significantly reduced at Aldrete Score ≥ 9 in the Desflurane group. Combined Z-scores at Aldrete Score ≥ 9 were (in medians [interquartils]): - 0.2 [- 1.2;+ 0.6] and - 0.4 [- 1.1;+ 0.4] for desflurane and propofol groups respectively (P = 0.62). Cognitive dysfunction at Aldrete score ≥ 9 was observed in 3 patients in the Propofol group and in 2 patients in the Desflurane group) (P = 0.93) | ||
| 520 | |a CONCLUSION: No difference was observed in cognitive status at Aldrete score ≥ 9 between desflurane and propofol anaesthesia. Although approximately 10% of patients still had cognitive dysfunctions, an Aldrete score ≥ 9 was associated with satisfactory cognitive function recovery in the majority of the patients after lower limb arthroplasty surgery under general anaesthesia | ||
| 520 | |a TRIAL REGISTRATION: Clinical Trials identifier NTC02036736 | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Anaesthesia | |
| 650 | 4 | |a Cognitive | |
| 650 | 4 | |a Desflurane | |
| 650 | 4 | |a PACU | |
| 650 | 4 | |a Propofol | |
| 650 | 7 | |a Anesthetics, Inhalation |2 NLM | |
| 650 | 7 | |a Anesthetics, Intravenous |2 NLM | |
| 650 | 7 | |a Desflurane |2 NLM | |
| 650 | 7 | |a CRS35BZ94Q |2 NLM | |
| 650 | 7 | |a Propofol |2 NLM | |
| 650 | 7 | |a YI7VU623SF |2 NLM | |
| 700 | 1 | |a Soulier, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Sciard, Didier |e verfasserin |4 aut | |
| 700 | 1 | |a Dufour, Guillaume |e verfasserin |4 aut | |
| 700 | 1 | |a Alberti, Corinne |e verfasserin |4 aut | |
| 700 | 1 | |a Boizeau, Priscilla |e verfasserin |4 aut | |
| 700 | 1 | |a Beaussier, Marc |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t BMC anesthesiology |d 2001 |g 21(2021), 1 vom: 11. März, Seite 76 |w (DE-627)NLM116144939 |x 1471-2253 |7 nnns |
| 773 | 1 | 8 | |g volume:21 |g year:2021 |g number:1 |g day:11 |g month:03 |g pages:76 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1186/s12871-021-01287-9 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 21 |j 2021 |e 1 |b 11 |c 03 |h 76 | ||