Neuropsychologic testing within 18 hours after cardiac surgery

Objective: To undertake neuropsychologic testing within 18 hours of cardiac surgery after fast-track anesthesia. Design: Prospective study. Setting: University hospital, single center. Participants: Fifty patients undergoing first-time elective coronary artery surgery. Interventions: A neuropsychologic test battery was administered preoperativ ely and 18 hours and 5 days after surgery. Main Results: Seven patients were withdrawn, and 9 patients did not attempt the postoperative tests (on both occasions) because of medical complicatio ns. Thirty patients completed greater than or equal to4 tests at both posto perative occasions. Of these, 9 patients (30%) showed a deficit in greater than or equal to2 tests at 18 hours postoperatively, and 3 (10%) showed a d eficit at 5 days postoperatively. Conclusion: In the absence of medical complications and despite the difficu lties, early postoperative neuropsychologic testing is possible after fast- track anesthesia. Such testing has the potential to more clearly define the course of cognitive decline after cardiac surgery. Copyright (C) 2001 by W .B. Saunders Company.