Aging prolongs recovery of psychomotor functions at emergence from propofol-alfentanil anaesthesia

Purpose: To compare recovery of psychomotor function in elderly and young s urgical patients at emergence from propofol-alfentanil anaesthesia. Methods: Ten elderly (> 70 yr) and IO younger (< 40 yr) patients scheduled for orthopaedic surgery of less than three hours. were anesthetized with ni trous oxide, propofol and alfentanil. Propofol and alfentanil cumulative do ses, time from cessation of propofol infusion to eye opening (EO) on verbal command and to extubation were recorded. Psychomotor performance was asses sed by the Mini-Mental State (MMS) performed the day prior to surgery and p ostoperatively at 30, 60, and 120 min. following extubation, Propofol blood concentrations were measured at EO and at each MMS task; Results: Elderly patients were comparable with young patients for preoperat ive MMS scores, surgery and anaesthesia duration, propofol and alfentanil c umulative doses. Postoperative MMS scores were lower at 30, 60 and 120 min. in elderly patients, Propofol blood concentrations were not different betw een elderly-and young patients at EO, 30, 60 and 120 min, Conclusion: Psychomotor performance is impaired in elderly compared with yo ung patients at emergence from propofol- alfentanil anaesthesia. These diff erences are not likely to be related to propofol accumulation in elderly su bjects.