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Research Article
Marc Beaussier
Institute Mutualiste Montsouris
Corresponding Author
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Background: The Aldrete's score is used to determine when a patient can safely leave the Post-Anaesthesia Care Unit (PACU) and be transferred to the surgical ward. The Aldrete score is based on the evaluation of vital signs and consciousness. Cognitive functions at the time the patient is judged fit for discharge from the PACU (Aldrete’s score ≥9) had not yet been studied. The aim of this trial was to assess the cognitive status of inpatients emerging either from desflurane or propofol anesthesia, at the time of PACU discharge (Aldrete score ≥9).
Methods: Sixty adult patients scheduled for hip or knee arthroplasty under general anesthesia were randomly allocated to receive either desflurane or propofol anesthesia. Patients were evaluated the day before surgery using Digit Symbol Substitution Test, Stroop Test and Verbal Learning Test. After surgery, the Aldrete score was checked every 5 min until reaching a score ≥9. At this time, the same battery of cognitive tests was applied. Every tests were evaluated separately. Cognitive status was reported using a combined Z score pooling together the results all 3 cognitive tests.
Results: Among the 3 tests, only DSST was significantly reduced at Aldrete Score ≥9 in the Dsflurane group. Combined Z-scores at Aldrete Score ≥9 were (in medians [interquartils]): -0.2 [-1.2;+0.6] and -0.4 [-1.1;+0.4] for desflurane and propofol groups respectively (P=0.62). The majority of patients did not present any cognitive dysfunction at Aldrete score ≥9 (24 patients out of 27 in the Propofol group and 23 patients out of 25 in the Desflurane group).
Conclusion: An Aldrete score ≥9 was associated with satisfactory cognitive function recovery in the majority of the patients after a lower limb arthroplastic surgery under general anesthesia. No difference was observed between desflurane and propofol. This reinforces the clinical value of Aldrete score to state about ability to leave the PACU in safety conditions.
Trial Registration: Clinical Trials identifier NCT 02036736
Keywords
Cognitive, Anesthesia, Desflurane, Propofol, PACU
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CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
Version 1
Posted 03 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 24 Dec, 2020
Reviews received
Received 13 Dec, 2020
Reviewers agreed
On 03 Dec, 2020
Reviewers invited
Invitations sent on 03 Dec, 2020
Editor assigned
On 03 Dec, 2020
Editor invited
On 30 Nov, 2020
Submission checks complete
On 30 Nov, 2020
First submitted
On 20 Nov, 2020
Metrics
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PDF Downloads: ...
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Subject Areas
Anesthesiology & Pain Medicine
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Anesthesiology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Marc Beaussier
Institute Mutualiste Montsouris
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
Version 1
Posted 03 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 24 Dec, 2020
Reviews received
Received 13 Dec, 2020
Reviewers agreed
On 03 Dec, 2020
Reviewers invited
Invitations sent on 03 Dec, 2020
Editor assigned
On 03 Dec, 2020
Editor invited
On 30 Nov, 2020
Submission checks complete
On 30 Nov, 2020
First submitted
On 20 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Anesthesiology.
Background: The Aldrete's score is used to determine when a patient can safely leave the Post-Anaesthesia Care Unit (PACU) and be transferred to the surgical ward. The Aldrete score is based on the evaluation of vital signs and consciousness. Cognitive functions at the time the patient is judged fit for discharge from the PACU (Aldrete’s score ≥9) had not yet been studied. The aim of this trial was to assess the cognitive status of inpatients emerging either from desflurane or propofol anesthesia, at the time of PACU discharge (Aldrete score ≥9).
Methods: Sixty adult patients scheduled for hip or knee arthroplasty under general anesthesia were randomly allocated to receive either desflurane or propofol anesthesia. Patients were evaluated the day before surgery using Digit Symbol Substitution Test, Stroop Test and Verbal Learning Test. After surgery, the Aldrete score was checked every 5 min until reaching a score ≥9. At this time, the same battery of cognitive tests was applied. Every tests were evaluated separately. Cognitive status was reported using a combined Z score pooling together the results all 3 cognitive tests.
Results: Among the 3 tests, only DSST was significantly reduced at Aldrete Score ≥9 in the Dsflurane group. Combined Z-scores at Aldrete Score ≥9 were (in medians [interquartils]): -0.2 [-1.2;+0.6] and -0.4 [-1.1;+0.4] for desflurane and propofol groups respectively (P=0.62). The majority of patients did not present any cognitive dysfunction at Aldrete score ≥9 (24 patients out of 27 in the Propofol group and 23 patients out of 25 in the Desflurane group).
Conclusion: An Aldrete score ≥9 was associated with satisfactory cognitive function recovery in the majority of the patients after a lower limb arthroplastic surgery under general anesthesia. No difference was observed between desflurane and propofol. This reinforces the clinical value of Aldrete score to state about ability to leave the PACU in safety conditions.
Trial Registration: Clinical Trials identifier NCT 02036736
Figure 1
Figure 2
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