Profile of recovery after general anaesthesia.

Abstract

The duration of impairment of mental functioning after anaesthesia was studied in 55 patients undergoing hernia repair who were divided into three groups in which the method of induction of anaesthesia (intravenous or inhalational) and ventilation (spontaneous or controlled) was varied. Performance in a five minute serial reaction time test and subjective estimates of coordination were assessed four times a day for two complete postoperative days and were compared with those in a control group of orthopaedic patients in hospital. After considerable impairment initially, reaction times in all groups gradually returned towards control values, but in patients breathing spontaneously during anaesthesia impairment recurred during the second postoperative day.These results suggest that such patients should be advised not to undertake hazardous tasks such as driving a car for at least 48 hours after a general anaesthetic. Discrepancies between subjective and objective assessments of impairment also suggest that patients should not rely on their own assessments of fitness to drive.

Mental Function After General Anaesthesia for Transurethral Procedures

“…There was also evidence suggesting that learning of the task was impaired for up to 2 days after anaesthesia. The data are consistent with an earlier reaction time study in middle-aged patients, which used a similar control group of orthopaedic patients, and halothane anaesthesia, and in which performance was impaired for up to 48 h after anaesthesia [10]. However, only means of blocks of reaction time trials were reported, and it was not possible to compare our data directly.…”

Effects of Glycemic Control on Protective Responses Against Hypoglycemia in Type 2 Diabetes

“…This test is very sensitive to acute hypoglycemia, showing deterioration in performance at plasma glucose levels of ~3 mmol/1 (10,(40)(41)(42)(43), which compares favorably with other cognitive tests (43)(44)(45)(46)(47). It is thus a good marker of cognitive function (48) and, in particular, measures a function that is likely to be relevant to the performance of complex tasks such as driving (21,22). It is important to recognize that four-choice reaction time is not (nor is it intended as) an estimate of global cognitive function.…”

“…We therefore studied counterregulatory hormone responses, symptoms, and fourchoice reaction time (as a marker of cognitive function [21,22]) during controlled experimental hypoglycemia in a group of seven poorly controlled type 2 patients, before and after improving glycemic control with insulin treatment, using a stepped hypoglycemic clamp protocol to allow determination of the plasma glucose thresholds at which these responses begin.…”

Altered Hierarchy of Protective Responses Against Severe Hypoglycemia in Normal Aging in Healthy Men

“…Subjects then trained on the apparatus for measuring four-choice reaction time (21,22). In this test, the subject is presented with a computer screen divided into four quadrants.…”