Recovery index, attentiveness and state of memory after xenon or isoflurane anaesthesia: a randomized controlled trial.
BACKGROUND
Performance of patients immediately after anaesthesia is an area of special interest and so a clinical trial was conducted to compare Xenon with Isoflurane anaesthesia. In order to assess the early cognitive recovery the syndrome short test (SST) according to Erzigkeit (Geromed GmbH) was applied.


METHODS
ASA I and II patients undergoing long and short surgical interventions were randomised to receive either general anaesthesia with Xenon or Isoflurane. The primary endpoint was the validated SST which covering memory disturbances and attentiveness. The test was used on the day prior to intervention, one and three hours post extubation. The secondary endpoint was the recovery index (RI) measured after the end of the inhalation of Xenon or Isoflurane. In addition the Aldrete score was evaluated up to 180 min. On the first post-operative day the patients rated the quality of the anaesthetic using a scoring system from 1-6.


RESULTS
The demographics of the groups were similar. The sum score of the SST delivered a clear trend one hour post extubation and a statistically significant superiority for Xenon three hours post extubation (p < 0.01). The RI likewise revealed a statistically significant superiority of Xenon 5 minutes post extubation (p < 0.01). The Aldrete score was significantly higher for 45 min. The scoring system results were also better after Xenon anaesthesia (p < 0.001).


CONCLUSIONS
The results show that recovery from anaesthesia and the early return of post-operative cognitive functions are significantly better after Xenon anaesthesia compared to Isoflurane. The results of the RI for Xenon are similar with the previously published results.


BACKGROUND
The trial was registered with the number ISRCTN01110844 http://www.controlled-trials.com/isrctn/pf/01110844.
Stuttmann
Ralph
R
Department of Anaesthesiology/Intensive Care and Emergency Medicine/Pain Therapy, BG-Kliniken Bergmannstrost, (Merseburger Strasse 165), Halle/Saale, (06112), Germany. ralph.stuttmann@bergmannstrost.com.
Jakubetz
Jens
J
Schultz
Kati
K
Schäfer
Claudia
C
Langer
Sebastian
S
Ullmann
Utz
U
Hilbert
Peter
P
Eur J Anaesthesiol. 2007 Apr;24(4):347-54
17087850
Lancet. 1998 Mar 21;351(9106):857-61
9525362
Int Psychogeriatr. 1997 Jun;9(2):123-38
9309486
Curr Opin Anaesthesiol. 2005 Aug;18(4):405-11
16534266
Anesthesiology. 2002 Jun;96(6):1351-7
12170047
Anaesthesia. 1999 Apr;54(4):335-46
10455831
Nagoya J Med Sci. 2005 Jun;67(3-4):93-9
17375475
Anaesthesist. 2008 Jan;57(1):9-30, 32-6
18209969
Br J Anaesth. 1999 Mar;82(3):355-9
10434815
Int Psychogeriatr. 1997;9 Suppl 1:115-21
9447434
Science. 1951 May 18;113(2942):580-2
14834873
Anesthesiology. 2003 Jan;98(1):6-13
12502972
Anesth Analg. 2001 Dec;93(6):1489-94, table of contents
11726429
Minerva Anestesiol. 2009 Jan-Feb;75(1-2):37-45
18475253
Int Psychogeriatr. 1997 Jun;9(2):139-53
9309487
Anesthesiology. 2001 Apr;94(4):611-4
11379681
Pharmacopsychiatry. 1999 Nov;32(6):248-54
10599935
Br J Anaesth. 2007 Jun;98(6):756-62
17485435
J Clin Anesth. 1995 Feb;7(1):89-91
7772368
Eur J Cardiothorac Surg. 1995;9(1):12-7
7727140
Arch Neurol. 1996 Oct;53(10):1033-9
8859066
Br Med Bull. 2005 Feb 22;71:115-35
15728132
Anesthesiology. 2009 May;110(5):1068-76
19352169
Anasth Intensivther Notfallmed. 1986 Apr;21(2):82-4
3728891
Ann Thorac Surg. 1995 May;59(5):1340-4
7733765
Anaesthesist. 1996 Feb;45(2):140-5
8720886
Anaesthesist. 1982;31(9):421-6
7149215
Arch Gerontol Geriatr. 2005 Jan-Feb;40(1):7-14
15531019
Br J Anaesth. 2000 Sep;85(3):359-63
11103174