Canadian Journal of Anesthesia

, 52:1017 | Cite as

Cognitive function is minimally impaired after ambulatory surgery

  • Barnaby Ward
  • Charles Imarengiaye
  • Javad Peirovy
  • Frances Chung
General Anesthesia



To evaluate the magnitude of subjective cognitive failure in the three days following general anesthesia (GA) for ambulatory surgery.


After Research Ethics Board approval, 258 patients undergoing general anesthesia (GA) and 250 patients scheduled for local anesthesia (LA) were recruited from our ambulatory surgical unit. Following the method of Tzabar, Asbury and Millar, patients were asked to complete the cognitive failures questionnaire (CFQ) before their procedure (with respect to the previous three days) and on the third postoperative day (with respect to their recovery period).


General anesthesia and LA groups were similar in demographic make-up, except that the LA group contained more patients of American Society of Anesthesiologists physical status I (64.5% vs 52.7%, P < 0.05) and had significantly shorter procedure duration (25 vs 51 min, P < 0.01) than the GA group. Median preoperative CFQ scores (interquartile range) were 26 (18) for the LA group and 26 (18) for the GA group. Postoperative CFQ scores were 25 (20) for the LA group and 28 (22) for the GA group. There was no significant difference in preoperative CFQ score between groups (Mann-Whitney U). When preoperative and postoperative CFQ scores were compared, the small increase seen in the GA group was statistically significant (P < 0.05, Wilcoxon).


A statistically significant impairment of cognitive function in the three days following GA, but not LA was found. However, the magnitude of this impairment was small, and is of doubtful clinical significance. Modern ambulatory anesthesia may cause less delayed cognitive impairment than was previously thought.


Sevoflurane Local Anesthesia Desflurane Anesthetic Technique Cognitive Failure 

La fonction cognitive est peu altérée après une intervention chirurgicale ambulatoire



Évaluer ľimportance de ľatteinte cognitive subjective au cours des trois jours suivant ľanesthésie générale (AG) pour une opération en chirurgie ambulatoire.


Le Comité ďéthique de la recherche ayant donné son accord, 258 patients devant subir une AG et 250 patients, une anesthésie locale (AL), ont été recrutés en chirurgie ambulatoire. Nous avons utilisé la méthode de Tzabar, Asbury et Millar et demandé aux patients de remplir le questionnaire sur les défaillances cognitives (QDC) avant leur opération (concernant les trois jours précédant ľopération) et le 3e jour postopératoire (selon la période de récupération).


La composition démographique des groupes AG et AL a été similaire, sauf que le groupe AL comptait plus de patients ďétat physique I ASA (64,5 % vs 52,7 %, P < 0,05) qui ont subi une opération significativement plus courte en moyenne (25 vs 51 min, P < 0,01) que ceux du groupe AG. Les scores préopératoires médians au QDC (intervalle interquartile) ont été de 26 (18) pour le groupe AL et de 26 (18) pour le groupe AG. Les scores post-opératoires ont été de 25 (20) pour le groupe AL et de 28 (22) pour le groupe AG. Il n’y a pas eu de différence significative de score préopératoire entre les groupes (test U de Mann-Whitney U). En comparant les scores préopératoires et postopératoires, on découvre une petite augmentation qui est statistiquement significative dans le groupe AG (P < 0,05, Wilcoxon).


Une atteinte statistiquement significative de la fonction cognitive a été trouvée pendant les trois jours qui ont suivi ľintervention chirurgicale sous AG mais non sous AL. Ľimportance de cette atteinte est toutefois minime et peu significative cliniquement. Ľanesthésie ambulatoire moderne cause moins ďatteinte cognitive différée qu’on ne ľavait ďabord cru.


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Copyright information

© Canadian Anesthesiologists 2005

Authors and Affiliations

  • Barnaby Ward
    • 1
  • Charles Imarengiaye
    • 1
  • Javad Peirovy
    • 1
  • Frances Chung
    • 1
  1. 1.Department of AnesthesiaToronto Western Hospital, University Health NetworkTorontoCanada

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