Psychomotor recovery in very old patients after total intravenous or balanced anaesthesia for cataract surgery

• Published in: British Journal of Anaesthesia Vol. 86; no. 2; pp. 203 - 208
• Main Authors: Kubitz, J, Epple, J, Bach, A, Motsch, J, Martin, E, Schmidt, H
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Elsevier Ltd 01.02.2001; Oxford University Press
• Subjects: age factors; Aged; Aged, 80 and over; anaesthesia, day-case; anaesthesia, geriatric; Anesthesia; Anesthesia depending on type of surgery; Anesthesia, General; Anesthesia, Intravenous; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, General - pharmacology; Anesthetics, Intravenous - pharmacology; Biological and medical sciences; Cataract Extraction; Female; Flicker Fusion - drug effects; Humans; Male; Medical sciences; Memory - drug effects; Orthopedic surgery. Maxillofacial surgery. Otorhinolaryngologic surgery. Stomatology. Ophtalmology. Investigation and treatment technics; Postoperative Period; Psychological Tests; Psychomotor Performance - drug effects; Reaction Time - drug effects; Single-Blind Method; age factors; anaesthesia, geriatric; anaesthesia, day-case; anaesthesia, geriatric; age factors; anaesthesia, day‐case; Human; Volatile compound; Postoperative; Cataract; Fentanyl; General anesthesia; Opiates; Cognition; Psychomotricity; Narcotic analgesic; Recovery; Isoflurane; Remifentanil; Eye disease; Lens disease; General anesthetic; Surgery; Awakening; Propofol; Technique; Elderly; Anterior segment disease; Comparative study; Halogen Organic compounds
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/86.2.203

We compared psychomotor recovery after total intravenous anaesthesia (TIVA) with remifentanil/propofol and balanced anaesthesia (BAL) with etomidate/fentanyl/isoflurane in 40 patients, ASA I–III, aged ≥80 yr undergoing elective cataract surgery. Recovery times were recorded and psychomotor recovery was assessed according to simple reaction time, critical flicker fusion frequency (CFF) and short-term memory 30 min, 2 h and 1 day after surgery. Physical characteristics of patients in the two groups (19 in the TIVA group and 21 in the BAL group) were comparable. The TIVA group recovered significantly more quickly. Both groups showed a poorer psychomotor performance 30 min after surgery than at baseline assessment, but simple reaction time and short-term memory were close to baseline values 2 h after surgery. Only performance in the CFF test remained below baseline at this point. No deficits in psychomotor performance were noted on the first day after surgery. We conclude that there is only a minor deficit in psychomotor function in elderly patients 2 h after cataract surgery under general anaesthesia and that psychomotor function recovers completely by 24 h after surgery.