Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-23T01:43:12.335Z Has data issue: false hasContentIssue false
  • English
  • Français

Impairment of sustained attention after major gynaecological surgery

Published online by Cambridge University Press:  13 October 2005

M. T. Dale ,
R. Naik ,
J. P. Williams ,
A. J. Lloyd  and
J. P. Thompson
M. T. Dale
Affiliation:
Leicester Royal Infirmary, University of Leicester and UHL NHS Trust, Division of Anaesthesia, Critical Care and Pain Management, Department of Cardiovascular Sciences, Leicester, UK
R. Naik
Affiliation:
Leicester Royal Infirmary, University of Leicester and UHL NHS Trust, Division of Anaesthesia, Critical Care and Pain Management, Department of Cardiovascular Sciences, Leicester, UK
J. P. Williams
Affiliation:
Leicester Royal Infirmary, University of Leicester and UHL NHS Trust, Division of Anaesthesia, Critical Care and Pain Management, Department of Cardiovascular Sciences, Leicester, UK
A. J. Lloyd
Affiliation:
Leicester Royal Infirmary, University of Leicester and UHL NHS Trust, Division of Anaesthesia, Critical Care and Pain Management, Department of Cardiovascular Sciences, Leicester, UK Current address: MEDTAP International Inc., 20 Bloomsbury Square, London WC1A 2NS, UK.
J. P. Thompson
Affiliation:
Leicester Royal Infirmary, University of Leicester and UHL NHS Trust, Division of Anaesthesia, Critical Care and Pain Management, Department of Cardiovascular Sciences, Leicester, UK
Get access

Extract

Summary

Background and objectives: The sustained attention to response task (SART) test is a sensitive indicator of deficits in sustained attention and is simple to perform. Sustained attention is impaired for a short period after minor surgery under general anaesthesia but the magnitude and duration of this effect after major surgery is unknown. We used the SART test to investigate deficits in sustained attention in patients undergoing major surgery under general anaesthesia. Methods: The SART test was completed before surgery and at 24, 48 and 72 h postoperatively by 20 ASA I–II female patients (mean age 48.6 yr) undergoing total abdominal hysterectomy under general anaesthesia. It was also completed by 20 age-matched female controls at similar time intervals to evaluate the effect of repeated test performance. Results: There was a significant (P < 0.05) interaction between the groups in number of errors made (a measure of sustained attention deficit). The number of errors decreased in control subjects on repeated performance of the SART test but remained unchanged in patients undergoing total abdominal hysterectomy. The differences between groups remained significant after 72 h (P < 0.05). Patients' overall response times slowed significantly at 24–48 h (P < 0.05), but this recovered by 72 h after surgery. In contrast, overall response times in the control group tended to accelerate on repeated performance of the SART. Conclusions: The results of this study suggest that 72 h following major surgery patients have deficits in sustained attention compared with controls. Control subjects demonstrated a marked learning effect on repeated test performance compared with patients.

Keywords

ANAESTHESIA RECOVERY PERIODSURGICAL PROCEDURES, OPERATIVE, hysterectomyPSYCHOMOTOR PERFORMANCE, task performance and analysis
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 11 , November 2005 , pp. 843 - 847
Copyright
© 2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

These data were presented in part at the Anaesthetic Research Society meeting, Glasgow, April 2003.

References

Moller JT, Cluitmans P, Rasmussen LS et al. Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study. Lancet 1998; 351: 857–861.Google Scholar
Johnstone T, Monk T, Rasmussen LS et al. Postoperative cognitive dysfunction in middle-aged patients. Anesthesiology 2002; 96: 1351–1357.Google Scholar
Canet J, Raeder J, Rasmussen LS et al. Cognitive dysfunction after minor surgery in the elderly. Acta Anaesthesiol Scand 2003; 47: 1204–1210.Google Scholar
Korttila KT. Post-anaesthetic psychomotor and cognitive function. Eur J Anaesthesiol 1995; 12: 43–46.Google Scholar
Bailie R, Christmas L, Price N, Restall J, Simpson P, Wesnes K. Effects of temazepam premedication on cognitive recovery following alfentanil-propofol anaesthesia. Br J Anaesth 1989; 63: 68–75.Google Scholar
Levin HS, High WM, Williams DH et al. Dichotic listening and manual performance in relation to magnetic resonance imaging after closed head injury. J Neurol Neurosurg Psychiatr 1989; 52: 1162–1169.Google Scholar
Stuss D, Gow AD. Frontal dysfunction after traumatic brain injury. Neuropsychiatr Neuropsychol Behav Neurol 1992; 5: 272–282.Google Scholar
Robertson IH, Manly T, Andrade J, Baddeley BT, Yiend J. ‘Oops!’: performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia 1997; 35: 747–758.Google Scholar
Manly T, Robertson IH, Galloway M, Hawkins K. The absent mind: further investigations of sustained attention to response. Neuropsychologia 1999; 37: 661–670.Google Scholar
Thompson JP, Rushman SC, Fox AJ, Lloyd AJ, Atcheson RA. Using the sustained attention to response test to detect cognitive dysfunction after day case surgery. Eur J Anaesthesiol 2002; 19: 585–588.Google Scholar
Meineke I, Freudenthaler S, Hofmann U et al. Pharmacokinetic modelling of morphine, morphine-3 glucuronide and morphine-6-glucuronide in plasma and cerebrospinal fluid of neurosurgical patients after short-term infusion of morphine. Br J Clin Pharmacol 2002; 54: 592–603.Google Scholar
Begg A, Drummond G, Tiplady B. Assessment of postsurgical recovery after discharge using a pen computer diary. Anaesthesia 2003; 58: 1101–1118.Google Scholar