A Comparison of the Postanesthetic Recovery of Cognitive and Psychomotor Function between Propofol Anesthesia and Enflurane Anesthesia

Park, Chong Min; Lee, Jai Min; Kim, Sung Nyeun

Abstract

BACKGROUND: For out-patient anesthesia a safe and rapid postoperative recovery, especially, the full recovery of psychological function for "street fitness" has become increasingly important. Up to the present, the scoring system - Steward postanesthesia recovery score - has been frequently used for the decision of discharge. But this system focuses on recovery of vital signs, other objective tests are needed to investigate cognitive and psychomotor function which is suitable for estimation of "street fitness".
METHODS
The propofol group(n=70) received fentanyl 0.8 ug/kg followed by propofol I mg/kg for anesthesia induction. Continuous propofol infusion was initiated upon induction. Ventilation was supported with N2 O-O2 mixture. The enflurane group(n=70) was induced with sodium thiopental 4 mg/kg. 2.0 vo1% of enflurane with N2 O-O2 mixture was initiated immediately upon induction. Both group received vecuronium 0.08 mg/kg as muscle relaxants. We measured Steward postanesthesia recovery score as scoring system and seven kinds of parameters as cognitive and psychomotor function test. The tests were performed at three measurement points; the day before the operation and 30, 60 minutes after extubation.
RESULTS
By the scoring system, no difference in recovery score at postop. 60 min. could be found between two groups. But by the cognitive and psychomotor function test, propofol group showed significantly better recovery than enflurane group at all tests, reaching control values at postop. 60 min.
CONCLUSIONS
The scoring system is not suitable method for decision of discharge, thus cognitive and psychomotor function test should be performed for "street fitness" after outpatient anesthesia. Propofol was associated with less impairment in cognitive and psychomotor function than enflurane.