Journal of Clinical Monitoring and Computing

, Volume 33, Issue 1, pp 107–113 | Cite as

Computerized tests to evaluate recovery of cognitive function after deep sedation with propofol and remifentanil for colonoscopy

  • Xavier BorratEmail author
  • Marta Ubre
  • Raquel Risco
  • Pedro L. Gambús
  • Angela Pedroso
  • Aina Iglesias
  • Gloria Fernandez-Esparrach
  • Àngels Ginés
  • Jaume Balust
  • Graciela Martínez-Palli
Original Research


The use of sedation for diagnostic procedures including gastrointestinal endoscopy is rapidly growing. Recovery of cognitive function after sedation is important because it would be important for most patients to resume safe, normal life soon after the procedure. Computerized tests have shown being accurate descriptors of cognitive function. The purpose of the present study was to evaluate the time course of cognitive function recovery after sedation with propofol and remifentanil. A prospective observational double blind clinical study conducted in 34 young healthy adults undergoing elective outpatient colonoscopy under sedation with the combination of propofol and remifentanil using a target controlled infusion system. Cognitive function was measured using a validated battery of computerized cognitive tests (Cogstate™, Melbourne, Australia) at different predefined times: prior to starting sedation (Tbaseline), and then 10 min (T10), 40 min (T40) and 120 min (T120) after the end of colonoscopy. Tests included the assessment of psychomotor function, attention, visual memory and working memory. All colonoscopies were completed (median time: 26 min) without significant adverse events. Patients received a median total dose of propofol and remifentanil of 149 mg and 98 µg, respectively. Psychomotor function and attention declined at T10 but were back to baseline values at T40 for all patients. The magnitude of psychomotor task reduction was large (d = 0.81) however 100% of patients were recovered at T40. Memory related tasks were not affected 10 min after ending sedation. Cognitive impairment in attention and psychomotor function after propofol and remifentanil sedation was significant and large and could be easily detected by computerized cognitive tests. Even though, patients were fully recovered 40 min after ending the procedure. From a cognitive recovery point of view, larger studies should be undertaken to propose adequate criteria for discharge after sedation.


Cognitive recovery Sedation Remifentanil Propofol Endoscopy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Xavier Borrat
    • 1
    • 2
    Email author
  • Marta Ubre
    • 1
  • Raquel Risco
    • 1
  • Pedro L. Gambús
    • 1
    • 2
    • 3
    • 5
  • Angela Pedroso
    • 4
  • Aina Iglesias
    • 2
  • Gloria Fernandez-Esparrach
    • 4
    • 5
    • 6
  • Àngels Ginés
    • 4
    • 5
    • 6
  • Jaume Balust
    • 1
  • Graciela Martínez-Palli
    • 1
    • 4
  1. 1.Anesthesiology DepartmentHospital ClínicBarcelonaSpain
  2. 2.Systems Pharmacology Effect Control & Modeling (SPEC-M) Research GroupBarcelonaSpain
  3. 3.Department of Anesthesia and Perioperative CareUniversity of California San Francisco (UCSF)San FranciscoUSA
  4. 4.Endoscopy Unit, ICMDiM, Hospital ClínicUniversity of BarcelonaBarcelonaSpain
  5. 5.Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS)BarcelonaSpain
  6. 6.Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD)BarcelonaSpain

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