Sanou J, Ilboudo D, Goodall G, Bourdallé-Badie C, Erny P
Department d'anesthésie-réanimation I, hôpital Pellegrin, Bordeaux, France.
Ann Fr Anesth Reanim. 1996;15(8):1155-61. doi: 10.1016/s0750-7658(97)85872-8.
To assess the disturbances and delay of recovery of cognitive functions following propofol anaesthesia, and to evaluate a series of simple cognitive recovery tests.
Prospective comparative non randomized clinical study.
Two groups of non premedicated patients, of ASA physical class 1 and 2 were studied. The control group (n = 11) included patients undergoing gastric fibroscopy under local anaesthesia. The propofol group (n = 22) consisted of patients scheduled for coloscopy under propofol anaesthesia.
The gastric fibroscopy was performed under local anaesthesia with lidocaine and the coloscopy under general anaesthesia with propofol as the sole anaesthetic. Five cognitive tests, designed to assess short-term memory, delayed memory, the ability to plan complex tasks, attention, and language comprehension were conducted the day before, and 1 hour, 3 hours and 6 hours after the endoscopy.
The cognitive functions remained significantly depressed for at least 3 hours after anaesthesia, and recovered fully about 6 hours after the cessation of propofol administration. The capacity for planning was the most heavily affected.
Complete recovery can be evaluated by simple cognitive tests, which showed that cognitive functions are impaired over a longer period than psychomotor functions. Oral instructions may therefore not be fully understood by the patient within 3 hours after anaesthesia, emphasizing the importance of written instructions and the essential role played by a well-informed accompanying person.
评估丙泊酚麻醉后认知功能的紊乱及恢复延迟情况，并评估一系列简单的认知恢复测试。
前瞻性比较非随机临床研究。
研究了两组未接受术前用药、美国麻醉医师协会（ASA）身体状况分级为1级和2级的患者。对照组（n = 11）包括在局部麻醉下接受胃镜检查的患者。丙泊酚组（n = 22）由计划在丙泊酚麻醉下接受结肠镜检查的患者组成。
胃镜检查在利多卡因局部麻醉下进行，结肠镜检查在以丙泊酚作为唯一麻醉剂的全身麻醉下进行。在内镜检查前一天以及检查结束后1小时、3小时和6小时进行了五项认知测试，旨在评估短期记忆、延迟记忆、计划复杂任务的能力、注意力和语言理解能力。
麻醉后认知功能至少在3小时内仍显著受抑制，在丙泊酚给药停止后约6小时完全恢复。计划能力受影响最严重。
通过简单的认知测试可以评估完全恢复情况，结果表明认知功能受损的时间比精神运动功能更长。因此，在麻醉后3小时内患者可能无法完全理解口头指示，这强调了书面指示的重要性以及知识渊博的陪同人员所起的关键作用。
