Mental Function After General Anaesthesia for Transurethral Procedures

Smith, Code; Carter, M.; Sebel, Peter S.; Yate, P.M.

doi:10.1093/bja/67.3.262

Cited by 21 publications

(6 citation statements)

References 15 publications

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“…To take the example of reaction time, impairment may be shown by sporadic long reaction times (reflecting lapses of attention that may have significance for safety) without an overall increase in the mean response time. The utility of the measure has been noted in recovery of adult choice reaction time performance following anaesthesia [22, 23], but it has been generally neglected as an indicator of impairment [24]. Table 2 showed that the GA1 group's choice reaction time and Coding performance at 48 h were characterised by significantly greater variance than that of the GA2 group or the control group at predischarge.…”

Section: Discussionmentioning

confidence: 99%

The effects of brief sevoflurane‐nitrous oxide anaesthesia upon children's postoperative cognition and behaviour

et al. 2006

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This study assessed the effects of brief sevoflurane-nitrous oxide anaesthesia on children's postoperative cognition, behaviour and physical morbidity. Forty-eight children aged 5-10 years undergoing anaesthesia without premedication for multiple dental extractions, and 48 control children, performed tests of choice reaction time, attention, psychomotor co-ordination and memory pre-operatively (baseline), prior to discharge and at 48 h (anaesthesia group only). Physical and psychological morbidity were recorded at 1 week. Mean choice reaction time and psychomotor co-ordination were significantly impaired postoperatively but had recovered at 48 h. However, measures of performance variability suggested the presence of residual impairment. Profound retrograde amnesia affected postoperative and 48-h recall of pictorial stimuli presented prior to anaesthesia, but recognition memory was unimpaired. Attention-seeking, tantrums, crying and nightmares were occurring more frequently in some 8-20% of children 1 week after the procedure.

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Section: Discussionmentioning

confidence: 99%

The effects of brief sevoflurane‐nitrous oxide anaesthesia upon children's postoperative cognition and behaviour

et al. 2006

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“…Practice effects have been noted for most neuropsychological tests both for volunteers (28–31), patients with chronic neurological disease (32, 33) and surgical patients (10, 34–39). Table 1 shows mean values and standard deviations for the Visual Verbal Learning test when administered to 176 elderly volunteers on three occasions.…”

Section: Neuropsychological Testing Of Surgical Patientsmentioning

confidence: 99%

The assessment of postoperative cognitive function

Rasmussen

Strandberg‐Larsen

Houx

et al. 2001

Acta Anaesthesiol Scand

494

403

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Postoperative cognitive function (POCD) has been subject to extensive research. In the literature, large differences are apparent in methodology such as the test batteries, the interval between sessions, the endpoints to be analysed, statistical methods, and how neuropsychological deficits are defined. Traditionally, intelligence tests or tests developed for clinical neuropsychology have been used. The tests for detecting POCD should be based on well-described sensitivity and suitability in relation to surgical patients. In tests using scores, floor/ceiling effects may compromise the evaluation if the tests are either too easy or to difficult. Uncontrolled testing facilities and change of test personnel may affect the test performance. Practice effects are pronounced in neuropsychological tests but have generally been ignored. The use of a suitable normative population is essential to allow correction for practice effects and variability between sessions. Missing follow-up may severely compromise valid conclusions since subjects unable or unwilling to be examined are particularly prone to suffer from POCD. In the statistical analysis of the test results, the evaluation should be based on differences between pre- and postoperative performance. Parametric statistical tests are not relevant unless the appropriate Gaussian distributions are present, perhaps after transformation of data. The definition of cognitive dysfunction should be restrictive and the criteria should be fulfilled in only a small proportion of volunteers. In the literature, these requirements often have not been fulfilled. This precludes a reasonable estimation of the incidence of POCD and the conclusions of comparative studies should be interpreted with great caution. In this review article, we present a number of recommendations for the design and execution of studies within this area. In addition, the critical reader may use these recommendations in the evaluation of the literature.

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“…Psychological tests, such as the mini mental status (MMS), have demonstrated that intrave nous sedation, the extent of surgery and the use of spinal or general anesthesia may also be of importance [1][2][3], Historically, confusion has been associated with profuse bleeding and massive absorption of irrigating fluid ('TUR syndrome'), but no author has evaluated the effects of these surgical complications on the mental status of the patient after TURP.…”

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confidence: 99%