title: Psychomotor dysfunction after remifentanil/propofol anaesthesia.
abstract: OBJECTIVE
  Early recovery after anaesthesia is gaining importance in fast track management. The aim of this study was to quantify psychomotor recovery within the first 24 h after propofol/remifentanil anaesthesia using the Short Performance Test (Syndrom Kurztest (SKT)), consisting of nine subtests. The hypothesis was that psychomotor performance remains reduced 24 h after anaesthesia.
  
  
  METHODS
  Thirty-seven patients scheduled for elective surgery took part in the study. The SKT was performed on the day before general anaesthesia (T0), 10, 30, 90 min and 24 h after extubation (T1). Parallel versions were used to minimize learning effects. Anaesthesia was introduced and maintained with remifentanil/propofol as a target controlled infusion. Propofol plasma concentration was measured 10 and 90 min after extubation. Perioperative pain management included novaminsulfon and piritramide.
  
  
  RESULTS
  Up till 90 min after surgery and anaesthesia, psychomotor performances were significantly reduced as the lower test results in all SKT subtests indicated (P < or = 0.007 vs. baseline T0). In the three memory subtests (ST 2, ST 8 and ST 9), psychomotor performance was still reduced on the first postoperative day (P < or = 0.005; T1 vs. T0). There was no correlation between propofol plasma concentration and the psychometric test results.
  
  
  CONCLUSIONS
  Propofol/remifentanil-based target controlled general anaesthesia for surgery is associated with a reduced psychomotor function up to the first postoperative day. Further studies are needed to confirm the usefulness of the SKT in the perioperative period and to clarify which components in the perioperative period are responsible for a lower performance in the SKT.
authors.affiliation: University Hospital Charité, Department of Anaesthesiology, Berlin, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Dressler
authors.forename: T
authors.initials: T
authors.lastname: Fritzsche
authors.forename: K
authors.initials: K
authors.lastname: Cortina
authors.forename: F
authors.initials: F
authors.lastname: Pragst
authors.forename: C
authors.initials: C
authors.lastname: Spies
authors.forename: I
authors.initials: I
authors.lastname: Rundshagen
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000758:Anesthesia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010880:Piperidines / Q000494:pharmacology*; D015742:Propofol / Q000494:pharmacology*; D011597:Psychomotor Performance / Q000187:drug effects*; D000077208:Remifentanil; D011795:Surveys and Questionnaires
chemical_list: D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol