Psychomotor Recovery After Outpatient Anaesthesia: Individual Impairment May Be Masked by Group Analysis

Hickey, Stephen; Asbury, A. J.; Millar, Keith

doi:10.1093/bja/66.3.345

Cited by 15 publications

(3 citation statements)

References 17 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was no evidence of significant residual psychomotor impairment at 48 h. Whilst the outcome accords with the sole earlier finding that impairment of children's postanaesthetic cognition had resolved within 24 h [1], both results must be interpreted cautiously because we have shown in the context of adult anaesthetic recovery that analyses based on group‐mean performance will tend to mask individual residual impairment [17]. Individual impairment can be estimated from statistical procedures including the use of standard scores and the construction of confidence intervals based on control group performance [6, 18–20].…”

Section: Discussionsupporting

confidence: 80%

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

et al. 2006

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 80%

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

et al. 2006

Self Cite

View full text Add to dashboard Cite

show abstract

“…For example, subject 28 demonstrated a wide range of results but his plasma propofol concentrations were within the range for his group. It is apparent that considerable variation may occur amongst individuals which may be masked by the analysis of the group as a whole [40].…”

Section: Discussionmentioning

confidence: 99%

The subjective effects of low‐dose propofol A double‐blind study to evaluate dimensions of sedation and consciousness with low‐dose propofol

Whitehead¹,

Sanders²,

Oldroyd³

et al. 1994

Anaesthesia

View full text Add to dashboard Cite

In this study the subjective effects (sedation and mood) of subanaesthetic doses of propofol were examined in 28 healthy male volunteers. A computer model was used to predict the infusion projiles necessary to obtain steady state propofol plasma concentrations of 0.3 pg.ml-', 0.6 pg.rn1-I. 0.9 pg.ml-'. Objective measures of sedation from saccadic eye movement and choice reaction time gave significant dose responses at each level but a battery of psychometric tests failed to show dose-related subjective responses. Of particular note in the subjective data is the lack of a drerence between groups or even of a consistent trend within the data. This suggests that a low concentration of propofol in plasma does not induce euphoria or a sense of wellbeing. The anecdotal evidence available for mood changes with propofol therefore remains unsubstantiated.

show abstract

“…The other test consisted of a choice reaction time (CRT) which was measured using a programme implemented on a hand-held Psion organizer. 8 Before the CRT test itself, preliminary instructions scroll across the screen, prompted by key presses by the patient. The final message is "Are you ready?-press the Y key to go on".…”

Section: Methodsmentioning

confidence: 99%

Comparison of patient-controlled sedation with either methohexitone or propofol

Hamid

McCann

McArdle

et al. 1996

British Journal of Anaesthesia

View full text Add to dashboard Cite

We studied 42 patients undergoing oral surgery under local anaesthesia with i.v. sedation, allocated randomly to receive either methohexitone (group M) or propofol (group P) for patient-controlled sedation (PCS). Group M patients self-administered 2.5-mg (0.5 ml) bolus doses of methohexitone and group P, 5-mg (0.5 ml) doses of propofol, without a lockout. The 0.5-ml bolus dose was delivered over 7.2 s for both drugs. The procedure was completed satisfactorily in all patients. Patients in both groups achieved their desired levels of sedation. No patient lost verbal contact. Group M patients had higher heart rates during the procedure. The lowest SpO2 values recorded were 92% and 95% for group P and group M, respectively. Immediately after operation patients in group M reported that they felt more sleepy than those in group P (P < 0.01) but there were no differences at subsequent times. The results of the psychomotor tests were comparable for the two groups after operation, except for the "posting box task" at 15 min after operation when the mean decrement (compared with preoperative performance) was -3% for group P and -13% for group M (P < 0.05). More patients in group P complained of pain in their hand. We conclude that methohexitone is a suitable alternative drug to propofol for PCS.

show abstract

Psychomotor Recovery After Outpatient Anaesthesia: Individual Impairment May Be Masked by Group Analysis

Cited by 15 publications

References 17 publications

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

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

The subjective effects of low‐dose propofol A double‐blind study to evaluate dimensions of sedation and consciousness with low‐dose propofol

Comparison of patient-controlled sedation with either methohexitone or propofol

Contact Info

Product

Resources

About