Cognitive failures after general anaesthesia for day-case surgery

Abstract

Patients are normally thought to have recovered from general anaesthesia within a few hours after day-case surgery. Previous recovery studies using objective psychometric tests showed a return to baseline values within this period. Nevertheless, patients are advised about what activities they should not undertake in the subsequent 24 h because it is feared that the residual anaesthetic effects may impair their ability. These studies did not follow patients out of hospital and their relevance to the real world is not known. Using the cognitive failures questionnaire, a standard measure of performance of everyday tasks, 54 patients were asked to report their own performance after general anaesthesia for the 3 days after discharge from hospital: 30 local anaesthetic patients were studied for comparison. The general anaesthesia group reported a highly significant greater incidence of cognitive failures after anaesthesia compared with the local anaesthesia group. This suggests that the residual effects of anaesthesia persist beyond 24 h.

Recovery of older patients undergoing ambulatory anaesthesia with isoflurane or sevoflurane

“…Alterations in cognitive function following general anaesthesia place patients at higher risks from postoperative adverse events. In one study, patients undergoing ambulatory anaesthesia reported significantly more cognitive failures, including failures of perception, memory or misdirected action, 3 days postoperatively, compared to patients undergoing procedures under local anaesthesia [15].…”

Dexmedetomidine may benefit cognitive function after laparoscopic cholecystectomy in elderly patients

“…The extent of patient recovery from the residual effects of anesthetics may be determined by clinical, psychomotor and cognitive tests (10). Cognitive function impairment occurs often and consistently, particularly in the elderly (11). …”

Psychomotor dysfunction after remifentanil/propofol anaesthesia

“…Tzabar and colleagues reported a greater number of cognitive lapses in younger patients when the patients used a cognitive failures questionnaire, which allows self-assessment. They did not use objective testing [5].…”