Jm. Raymond et al., QUALITY OF PSYCHOMOTOR RECOVERY AFTER COL ONOSCOPY UNDER GENERAL-ANESTHESIA WITH PROPOFOL - IMPORTANCE OF AWAKENING-TESTS, Gastroenterologie clinique et biologique, 19(4), 1995, pp. 373-377
Achieving colonoscopy under general anaesthesia entails the problem of
ambulatory-care anaesthesia, in particular because perception of pati
ent's recovery determines to some extent the length of monitoring foll
owing colonoscopy. The aims of the study was to assess the quality of
patient's recovery after a colonoscopy under general anaesthesia while
using propofol, by means of psychomotor-tests. Methods. - Colonoscopy
was performed in 40 patients according to the following anaesthesic p
rotocol: induction: propofol 2 mg/kg, continuous support: propofol 10
mg/kg/h IV with a 50 mg bolus in case of insufficient sedation; series
of 3 psychomotor-tests were performed the day before and 1 hour, 3 ho
urs and 6 hours after colonoscopy. The 3 psychomotor tests studied: co
ordination (Newman test), time-space orientation and short-term memory
. Results. - Forty patients, 25 females and 15 mates, underwent colono
scopy with general anaesthesia for an average time-period of 22 +/- 11
min. The mean dose of propofol used was 286 +/- 102 mg. Awakening was
complete in all patients, according to physical criteria such as cons
ciousness and cardiovascular status, 20 min after receiving colonoscop
y. The average psychomotor-tests results over time were (as percentage
s of original values) ( P < 10(-3);**P < 0.05): retained 90 % their f
ormer state as measured with 3 psychomotor-tests. Neither by age or se
x nor by propofol doses used or length or anaesthesia, the study popul
ation differed significantly. Conclusion. - Three hours after colonosc
opy under general anaesthesia using propofol, 30 patients (75 %) had r
ecovered at least 90 % to their initial performances. Newman test was
the most disturbed but there was no predictive factor for the quality
of recovery. Psychomotor tests may be useful before authorizing early
discharge after colonoscopy under general anaesthesia but other recomm
endations about conditions of discharge after sedation must be also im
plemented.