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PubMed1998

Community's role in the promotion of recovery from addiction and prevention of relapse among women: an exploratory study.

OBJECTIVE: This exploratory study examined the community's role in the promotion of recovery from addiction and the prevention of relapse among women, and the differences in women's addiction and recovery by ethnicity. Community was defined as six institutions: home, church, workplace, school, law enforcement and medical care system. METHODS: The study sample consisted of 39 Anglo and 24 ethnic minority women (21 African American; 3 Hispanic) between the ages of 21 and 70, living along the Gulf Coast of Texas, who had been in continuous recovery from addiction to alcohol or other drugs for at least six months. The study was cross-sectional, and data were collected through the use of structured interviews utilizing the Women in Recovery Questionnaire, an instrument developed by the investigative team. RESULTS: This study found that community institutions (church, school, home, workplace and law enforcement and medical systems) were seldom involved in promoting recovery or preventing relapse in women, with the exception of the home, which supported recovery. Anglo and ethnic minority women differed by primary drug usage, number of times in treatment, religion, perception of sexism, and likelihood of citations for traffic violations. CONCLUSION: Large, randomized studies are needed to investigate the community's role in women's recovery from alcohol and other drugs.

Adult↗

PubMed1998

ECG changes during dobutamine stress test and spontaneous recovery of contractility in patients with myocardial infarction.

UNLABELLED: Recent reports suggest a relationship between ECG changes and myocardial viability during dobutamine stress echocardiography in patients with myocardial infarction. The aim of the study was to analyze the predictive value of T-wave normalization and ST segment elevation during low- (10 mucg/Kg/m') and high-dose (40 mucg/Kg/m') dobutamine stress test for late spontaneous recovery of function in patients with a first uncomplicated Q-wave myocardial infarction. METHODS: Seventy eight consecutive patients (59 +/- 9 yrs; males = 67; anterior MI = 41, inferoposterior MI = 37 pts) underwent baseline 2D echo and dobutamine stress test at 9 +/- 2 days from onset of symptoms and they were free of cardiac events during the first three months after myocardial infarction. T-wave normalization (negative T-wave becoming > or = 1 mm upright in > or = 2 leads) and ST segment elevation (> or = 0.1 mm in > or = 2 leads) at low- and high-dose dobutamine infusion were compared with an improvement of contractility in the infarct area detected echocardiographically at three months. A wall motion score decrease in infarct area > or = 2 was the criterion for recovery of contractility. RESULTS: ST segment elevation occurred in 19/78 patients at low dose (24%) and in 45/78 patients at high dose (58%). Late recovery of contractility in the infarct area was observed in 38/78 patients (49%). The positive and negative predictive values of ST segment elevation for late recovery of contractility were, respectively, 63-56% at low dose and 47-48% at high dose. A baseline negative T-wave in > or = 2 leads was present in 56 patients, and 27 (48%) showed recovery of contractility at three months. T-wave normalization occurred in 14 patients at low-dose (25%) and in 29 patients at high-dose dobutamine infusion (52%). The positive and negative predictive values of T-wave normalization were, respectively, 71-59% at low dose and 62-67% at high dose. Both ECG markers were present in 10/56 patients at low dose and in 19 patients at high dose. The positive and negative predictive values, respectively, were 70-57% at low dose and 58-57% at high dose. At univariate analysis, neither the ECG changes alone nor their combination during dobutamine stress testing were shown to be significant predictors of recovery of function. CONCLUSIONS: Our study demonstrates that in patients with a first uncomplicated Q-wave myocardial infarction, the T-wave normalization and/or the ST segment elevation occurring during early dobutamine stress testing are not reliable predictors of late spontaneous recovery of contractility in the infarct area.

Adrenergic beta-Agonists↗

PubMed1998

[Diagnostic value of ST depression corrected for heart rate in the post-exercise recovery period].

This study assessed the diagnostic value of two new electrocardiographic criteria of coronary artery disease: the ST/HR index and the slope of the linear relationship between ST segment changes and the heart rate during the first three minutes of the post-exercise recovery period. These two criteria were compared to the standard criteria (> or = 1 mm horizontal or descending ST depression or > or = 2 mm ascending ST depression) to Detrano's ST/HR exercise index (> 1.6 microV/bpm in coronary patient), the exercise ST/HR slope (> or = 2.4 microV/bpm in coronary patients) and the exercise recovery loop (clockwise in normal and anticlockwise in coronary patients) in 88 subjects investigated for suspected coronary artery disease who underwent a computerised exercise stress test and coronary angiography (25 single vessel, 21 double vessel, 20 triple vessel disease; 22 with no significant coronary disease). The ROC identified thresholds of abnormality of the ST/HR recovery index at > or = 2.1 microV/bpm and of the ST/HR recovery slope at > or = 2.52 microV/bpm. Global comparison of the areas under the ROC showed the diagnostic superiority of the exercise ST/HR indices (0.96) over the standard criteria (0.92) and recovery indices (0.86) but without statistically significant values (p = 0.65 and p = 0.15 respectively). The ST/HR index and slope during recovery identify coronary disease with a diagnostic accuracy of 80% and 77% respectively which is similar to that (84%) of the standard ST criteria. The exercise-recovery loop was less accurate (64%).

Aged↗

PubMedDate not supplied

Comparative mold and yeast recovery analysis (the effect of differing incubation temperature ranges and growth media).

Environmental monitoring methodology for recovering fungal organisms often dictates the use of a selective medium incubated at ambient temperatures (20-25 degrees C) for as many as seven days incubation to ensure reliable recovery. However, these methods (which must remain standardized for identification purposes) are not the only avenue environmental monitoring programs may follow. This study comparatively analyzed recovery rates of fungal organisms cultured on both a general purpose bacteriological nutrient medium (Tryptic Soy Agar supplemented with Lecithin and Polysorbate 80), and on a medium selective for the growth of yeasts and molds (Sabouraud Dextrose Agar). The bacteriologic medium was incubated at elevated temperatures (30-35 degrees C) for 70-72 hours then transferred to ambient temperatures for another 70-72 hours incubation. The control case selective medium was incubated solely at 20-25 degrees C for 110-130 hours. Additionally, in a separate test the selective medium was incubated at the same temperature and time specifications as the bacteriologic medium to analyze recovery capabilities. Equivalent or better recovery was obtained for all test panel organisms of yeasts and molds using Tryptic Soy Agar supplemented with Lecithin and Polysorbate 80 incubated at 30-35 degrees C. Equivalent or better recovery was obtained for eight of the nine test panel organisms of yeasts and molds incubated at elevated temperatures on Sabouraud Dextrose Agar versus recovery on Agar versus recovery on Sabouraud Dextrose Agar incubated solely at 20-25 degrees C. No inhibition of growth was observed at the elevated temperature range of 30-35 degrees C. Three days incubation at elevated temperatures was a sufficient incubation period to detect the test organisms cultured on Tryptic Soy Agar supplemented with Lecithin and Polysorbate 80.

Culture Media↗

PubMed2026

Muscle Massage Adding Capacitive Resistive Electric Transfer Therapy in Active or Sham Condition for Post-Exercise Recovery in Athletes: A Crossover Clinical Trial.

The increasing demands of elite sports reduce recovery time, impair performance, and increase injury risk. Efficient lactate transport is essential for postexercise recovery. Capacitive resistive electric transfer (CRET) therapy enhances deep tissue heating, induces vasodilation, and promotes circulation. To evaluate whether adding active CRET to a standardized muscle recovery massage, compared with the same massage plus sham CRET, influences indicators of muscle recovery following a maximal anaerobic effort test. A randomized, single-blind, sham-controlled, and crossover clinical trial was conducted in 25 athletes. Participants completed four visits and, after the maximal power and anaerobic capacity test (Wingate test), received a standardized muscle recovery massage combined with either active CRET or sham CRET. Blood lactate levels, muscle oxygenation, muscle thickness, echogenicity, knee extension force, and muscle activity were assessed before and after the test, after treatment, and 24 hours later. Compared with massage plus sham CRET, massage plus active CRET was associated with lower blood lactate concentration at 60 min postexercise (p = 0.029). Ultrasound-derived muscle thickness and echogenicity also differed between conditions at several time points (p < 0.05). However, no significant differences were observed in Wingate test performance, force, muscle activity, and oxygenation between conditions. In athletes performing repeated Wingate exercise, adding active CRET to massage was associated with lower blood lactate concentration at 60 min postexercise and with differences in ultrasound-derived muscle thickness and echogenicity compared with sham CRET plus massage. However, these between-condition differences were not accompanied by clear short-term functional recovery benefits. TRIAL REGISTRATION: NCT06906146.

Humans↗

PubMed2026

Effect of ketofol versus Fentanyl-Midazolam sedation on neurological recovery in traumatic brain Injury: A randomised study.

Neurological recovery after traumatic brain injury (TBI) is multifactorial, and sedation is a cornerstone of neurocritical care because of its neuroprotective role. Although ketofol is widely used for anaesthesia, its effectiveness as a sedative regimen in the intensive care unit (ICU) has not been well studied. This preliminary exploratory double-blind, randomised study compared ketofol (KP) with fentanyl-midazolam (FM) sedation in adults with moderate-to-severe TBI. Sedation was administered for 72 h and titrated to a Richmond Agitation-Sedation Scale (RASS) score ≤  - 3. The primary outcome was the Extended Glasgow Outcome Scale (GOSE) at 30 days. Secondary outcomes included GOSE at 90 days, incidence of propofol infusion syndrome (PRIS), duration of mechanical ventilation, haemodynamic stability, and ICU and hospital length of stay. Of 120 enrolled patients, 111 were included in the final analysis (57 FM, 54 KP). Baseline characteristics, including injury severity and Marshall CT scores, were comparable. At 30 days, good neurological recovery (GOSE 7-8) was more frequent in the KP group than the FM group (26% vs. 10.5%, p = 0.03). At 90 days, recovery remained higher with KP (44.4% vs. 33.3%), though the difference was not statistically significant (p = 0.16). Multivariate analysis confirmed ketofol as an independent predictor of good recovery at 30 days (adjusted OR 3.63, 95% CI 1.11-11.85, p = 0.033). No PRIS occurred, and secondary outcomes were similar. Ketofol-based sedation was safe and may be associated with improved early neurological recovery compared with fentanyl-midazolam, with a favourable trend toward improved long-term neurological recovery.

Humans↗

PubMed2004

Fast-track eligibility, costs and quality of recovery after intravenous anaesthesia with propofol-remifentanil versus balanced anaesthesia with isoflurane-alfentanil.

BACKGROUND AND OBJECTIVE: The randomized, patient- and observer-blinded study was performed in 120 patients undergoing ear, nose and throat surgery to test the hypothesis that intravenous anaesthesia with propofol-remifentanil when compared with a balanced anaesthesia technique using isoflurane-alfentanil improves the speed of recovery, minimizes postoperative side-effects and, thus, leads to an improved quality of recovery without increasing total costs. METHODS: The total costs for each anaesthesia technique were calculated considering drug acquisition costs, personnel costs for the additional time spent in the operating room and the postanaesthesia care unit until fast-tracking eligibility, and the costs to treat the side-effects during and after operation. RESULTS: The times from the end of surgery to tracheal extubation and the time until leaving the operating room were not different between the two groups. However, more patients receiving intravenous anaesthesia (80 versus 49%) were eligible for fast tracking and thus could bypass the recovery room. This was associated with an average cost saving of 6.00 euros per patient. However, intravenous anaesthesia was associated with higher total costs (89 euros versus 78 euros) mainly because of higher acquisition costs of the anaesthetics (34.60 euros versus 16.50 euros). There was no difference in the quality of recovery as measured by a Quality of Recovery score and patient satisfaction between the two groups. CONCLUSIONS: The higher acquisition costs of the intravenous anaesthetics propofol and remifentanil cannot be compensated for by improved speed of recovery. This anaesthesia technique is more cost intensive than balanced anaesthesia using isoflurane and alfentanil.

Adult↗

PubMed1989

Recovery from anaesthesia in children.

There are no published comprehensive surveys of paediatric recovery room experience and the incidence of complications. A prospective survey was made of 16,700 consecutive admissions to the recovery room at the Royal Manchester Children's Hospital during the years 1985-1988. The incidence of respiratory complications was low, with laryngospasm 0.85%. The incidence of hypotension was higher than that in adult studies; over 50% of children recorded a decrease in blood pressure in the recovery room of more than 20%, compared to values before operation. The incidence of vomiting in the recovery room was also lower than in comparable adult studies. Certain aspects of recovery room practice changed during the 4 years of the study; these included routine oxygen administration, parents in the recovery room, and our approach to postoperative analgesia. The implications of these changes are discussed.

Anesthesia Recovery Period↗

PubMed1991

A review of 6978 consecutive admissions to the recovery room at a university hospital.

Recovery from anaesthesia is a time of potential danger to the surgical patients. A retrospective audit of all recovery room admissions over a period of 18 months was carried out at the Aga Khan University Hospital. During this period 6978 patients were admitted to the recovery area and 695 had one or more complications. The complications were recorded by the recovery room nursing staff in a recovery log book. The breakdown of complications according to different physiological systems is discussed. Several surveys have reviewed complications in the western population, but in contrast, no study is available in Pakistani patients. It is recommended that since one in ten patients is likely to have a problem in the early post-operative period, the local hospitals should provide adequate facilities meeting the criteria laid down for the recovery rooms in modern anaesthetic practice.

Adult↗

PubMed2000

Self-reported at-home postoperative recovery.

Although 75% of elective surgery is performed on an outpatient basis, no measures of patients' at-home postoperative recovery were found in the literature. The postdischarge surgical recovery (PSR) scale was designed to serve as a dependent variable capable of measuring variations in perceived recovery in patients dismissed within 24 hours of their surgical procedure. Five concepts: health status; activity; fatigue; work ability; and expectations, derived from an ethnographic analysis, are represented in the 15-item 10-point semantic differential scale. The PSR scale exhibited strong internal consistency in two samples (alpha=.88-.91). The concurrent validity coefficient between the PSR scale and the previously tested Wolfer-Davis Recovery Inventory (1970) was .76 (n = 163; p< or =.001). Construct validity was supported by the relationship (r=.72, p< or =.001) between patients' reported percentage of recovery (0-100%) and PSR scores. Construct val idity was also supported by correlations between the PSR scale and in-home assessment by a master clinical nurse specialist (r=.77, p=.003, n=12) and by trained in-home observers (r=.71, p< or =.001, n=59). Clinicians or researchers interested in the extent of perceived at-home Postoperative recovery may now search for symptom patterns and changes over time in a variety of ambulatory surgery patients using the PSR scale.

Adult↗

PubMed2007

A protocol is not enough to implement an enhanced recovery programme for colorectal resection.

BACKGROUND: Single-centre studies have suggested that enhanced recovery can be achieved with multimodal perioperative care protocols. This international observational study evaluated the implementation of an enhanced recovery programme in five European centres and examined the determinants affecting recovery and length of hospital stay. METHODS: Four hundred and twenty-five consecutive patients undergoing elective open colorectal resection above the peritoneal reflection between January 2001 and January 2004 were enrolled in a protocol that defined multiple perioperative care elements. One centre had been developing multimodal perioperative care for 10 years, whereas the other four had previously undertaken traditional care. RESULTS: The case mix was similar between centres. Protocol compliance before and during the surgical procedure was high, but it was low in the immediate postoperative phase. Patients fulfilled predetermined recovery criteria a median of 3 days after operation but were actually discharged a median of 5 days after surgery. Delay in discharge and the development of major complications prolonged length of stay. Previous experience with fast-track surgery was associated with a shorter hospital stay. CONCLUSION: Functional recovery in 3 days after colorectal resection could be achieved in daily practice. A protocol is not enough to enable discharge of patients on the day of functional recovery; more experience and better organization of care may be required.

Aged↗

PubMed2000

Is dosage of physiotherapy a critical factor in deciding patterns of recovery from stroke: a pragmatic randomized controlled trial.

BACKGROUND AND PURPOSE: The best treatment and management of stroke patients has been shown to be in stroke units by multidisciplinary rehabilitation teams. Since the composition of stroke units differs it is important to know the extent to which the different components contribute to this results. Physiotherapy is one component of most rehabilitation teams and recent systematic reviews have shown that patients with stroke receiving more physiotherapy achieve more recovery from disability. However, information about the actual amounts of physiotherapy needed to achieve this result is not known. METHOD: A pragmatic, randomized, single-blind, controlled trial comparing recovery from disability in subjects receiving the current standard amount of 30 minutes' physiotherapy with those receiving double that amount (60 minutes). The study included measures of physical performance and function, psychological aspects of anxiety and depression, and perceived control over recovery. RESULTS: Some 114 subjects were recruited to the study; full six-week data are available for 104 subjects and six-month data for 93 subjects. Comparison of initial to six-week difference scores in the control and intervention groups of the whole sample did not show a significant difference. Scrutiny of the recovery curves of the whole sample showed that, in half the sample, three distinct patterns of recovery were demonstrated. CONCLUSION: These results suggest that doubling the physiotherapy time available for patients in a stroke unit will not provide a measurable benefit for all patients. The subgroup analysis of patterns of recovery must be regarded as speculative, but provides the basis for hypotheses about those likely to respond well to more intensive therapy.

Activities of Daily Living↗

PubMed2001

The simultaneous activation hypothesis: explaining recovery from deep to phonological dyslexia.

Deep dyslexia evolved into phonological dyslexia in one patient. Semantic errors resolved while phonological and derivational errors persisted in reading. Nonword reading improved but remained inferior to word reading. Despite a residual semantic deficit naming improved. The Simultaneous Activation Hypothesis explains recovery from deep to phonological dyslexia and the continued dissociation between reading and naming errors. Partial recovery to all three reading routes increased constraints for word selection at the phonological output lexicon (POL) improving word reading. With recovery, the POL receives additional supportive information from the partially recovered direct oral reading route and grapheme-to-phoneme conversion (GPC) eliminating semantic errors in oral reading. Nonword reading also improved because of partial recovery to all three routes. Semantic errors in naming persisted because additional constraints were unavailable at the POL to activate a phonological entry. Phonological and derivational errors were more frequent in reading than in naming the result of incomplete GPC recovery. Residual nonword reading deficits resulted from incomplete GPC recovery, indicated by the persistence of neologisms in nonwords. The Simultaneous Activation Hypothesis readily accounts for the evolution from deep to phonological dyslexia.

Adult↗

PubMed1999

Improved functional recovery of ischemic rat hearts due to singlet oxygen scavengers histidine and carnosine.

There is increasing evidence that reactive oxygen species (ROS) contribute to post-ischemic reperfusion injury, but determination of the specific ROS involved has proven elusive. In the present study electron paramagnetic resonance (EPR) spectroscopy was used in vitro to measure the relative quenching of singlet oxygen (1O2) by histidine and carnosine (beta-alanyl-L-histidine) utilizing the hindered secondary amine 2,2,6,6-tetramethyl-4-piperidone HCl (4-oxo-TEMP). The relative effect of histidine and carnosine on functional recovery of isolated perfused rat hearts was also studied. Functional recovery was measured by left ventricular developed pressure (LVDP), first derivative of left ventricular pressure (dP/dt), heart rate (HR) and coronary flow (CF). EPR measurements and Stern-Volmer plots showed that 400 microM carnosine quenched 1O2 twice as effectively as equimolar histidine in vitro. Moreover, 10 mM histidine improved functional recovery of isolated rat hearts significantly more than 1 mM histidine. Furthermore, 1 mM carnosine improved functional recovery significantly more than equimolar histidine and as effectively as 10 mM histidine. Experiments with 1 mM mannitol, a known hydroxyl radical scavenger, did not show an improvement in functional recovery relative to control hearts, thereby decreasing the likelihood that hydroxyl radicals are the major damaging species. On the other hand, the correlation between improved functional recovery of isolated rat hearts with histidine and carnosine and their relative 1O2 quenching effectiveness in vitro provides indirect evidence for 1O2 as ROS participating in reperfusion injury.

Animals↗

PubMed2005

Early clinical predictive factors during coma recovery.

In severe brain injury patients few studies have examined the role of early clinical factors emerging before recovery of consciousness. Patients suffering from vegetative state and minimally conscious state in fact may need variable periods of time for recovery of the ability to follow commands. In a previous study we retrospectively examined a population of very severe traumatic brain injury patients with coma duration of at least 15 days (prolonged coma), and we found, as significant predictive factors for the final outcome, the time interval from brain injury to the recovery of the following clinical variables: optical fixation, spontaneous motor activity and first safe oral feeding. Psychomotor agitation and bulimia during coma recovery were also favourable prognostic factors for the final outcome. In a further study, also as for the neuropsychological recovery, the clinical variable with the best significant predictive value was the interval from head trauma to the recovery of safe oral feeding. In the present study the presence of psychomotor agitation diagnosed by means of LCF (score 4 = confused-agitated) at the admission time in rehabilitation predicted a statistically significant better outcome at the discharge time in comparison with patients without agitation.

Coma, Post-Head Injury↗

PubMed1999

Sevoflurane-maintained anesthesia induced with propofol or sevoflurane in small children: induction and recovery characteristics.

PURPOSE: To compare the induction and recovery characteristics of sevoflurane anesthesia induced with either propofol or sevoflurane in pediatric outpatients. METHODS: Fifty-two children, aged 1-3 yr, presenting for ambulatory adenoidectomy were randomly allocated to receive 3 mg.kg-1 propofol i.v. or sevoflurane 8% inspired concentration for induction of anesthesia. Tracheal intubation was facilitated with 0.2 mg.kg-1 mivacurium. Anesthesia was maintained with nitrous oxide/oxygen (FiO2 0.3) and sevoflurane approximately 3-5% inspired concentration with controlled ventilation. Intubation was assessed by an anesthetist blinded to the induction method. Recovery characteristics were compared using the modified Aldrete scoring system, the Pain/Discomfort scale and measuring specific recovery times. A postoperative questionnaire was used to evaluate the children's well-being at home. RESULTS: Intubating conditions were similar in both groups. Emergence from anesthesia occurred earlier with sevoflurane for induction than with propofol (11 +/- 4 vs 17 +/- 7 min (mean +/- SD), P = 0.0002). More children in the sevoflurane group achieved full points on the modified Aldrete scoring system during the first 20 min after anesthesia (P < 0.05). However, children in the sevoflurane group scored higher in the Pain/Discomfort scale at 10 min after anesthesia (P = 0.04) and were given postoperative analgesics earlier than children in the propofol group (13 +/- 5 min vs 18 +/- 11 min, P = 0.03). The time to meet discharge criteria and recovery at home were similar. CONCLUSIONS: Induction of sevoflurane anesthesia with propofol for day-case adenoidectomy results in longer, but more calm, early recovery but does not delay discharge or affect recovery at home.

Adenoidectomy↗

PubMed1999

Midazolam premedication delays recovery from propofol-induced sevoflurane anesthesia in children 1-3 yr.

PURPOSE: To study the effect of midazolam premedication on the recovery characteristics of sevoflurane anesthesia induced with propofol in pediatric outpatients. METHODS: Sixty children, one to three years, presenting for ambulatory adenoidectomy were randomly assigned , in a double-blind fashion, to receive either 0.5 mg x kg(-1) midazolam (Group M) or placebo (Group P) p.o. 30 min before anesthesia. Anesthesia was induced with 10 microg x kg(-1) atropine, 10 microg x kg(-1) alfentanil, and 3-4 mg x kg(-1) propofol i.v.. Tracheal intubation was facilitated with 0.2 mg x kg(-1) mivacurium. Anesthesia was maintained with nitrous oxide/oxygen (FiO2 0.3) and sevoflurane with controlled ventilation. Recovery characteristics were compared using the modified Aldrete scoring system, the Pain/Discomfort scale and measuring specific recovery end-points (emergence, full Aldrete score, discharge). A postoperative questionnaire was used to evaluate the children's well-being at home until 24 hr after discharge. RESULTS: Emergence from anesthesia (22 +/- 9 vs 16 +/- 6 min (mean +/- SD), P = 0.005) and achieving full Aldrete scores (30 +/- 11 vs 24 +/- 16 min, P = 0.006) were delayed in patients receiving midazolam. Children in the placebo group were given postoperative analgesia sooner than those in the midazolam group (18 +/- 11 vs 23 +/- 8 min, P = 0.009). More children premedicated with midazolam suffered from arousal distress (20% vs 3%, P = 0.04) and scored higher on the Pain/Discomfort scale (P = 0.004) at 20 min after arrival in the recovery room. Discharge was not affected by premedication and well-being at home was similar in the groups. CONCLUSIONS: Oral premedication with midazolam delays early recovery but not discharge after ambulatory sevoflurane anesthesia induced with propofol in children one to three years. Midazolam did not improve the quality of recovery.

Adenoidectomy↗

PubMed2002

Recovery of psychomotor function after propofol sedation is prolonged in the elderly.

PURPOSE: To assess the effects of age on recovery of psychomotor function for propofol sedation during spinal anesthesia. METHODS: Propofol was continuously infused during surgery and spinal anesthesia in 15 elderly patients (65-85 yr-old) and 15 younger patients (20-50 yr-old). Infusion rates were adjusted to maintain an appropriate level of sedation using the bispectral index (range 60-70). The sedative infusion was discontinued at the end of surgery. The early recovery times from the end of propofol infusion to opening of eyes on command, sustaining a hand grip, and recall of name were noted. Psychomotor function, as measured by the Trieger's dot test, was evaluated before anesthesia and 30, 60, 90, 120 min after the end of propofol infusion. RESULTS: The duration of anesthesia was 142 +/- 55 min and 134 +/- 61 min in the elderly and younger patients, respectively. No differences were observed in early recovery times between elderly and younger patients (opened their eyes on command, 6.3 +/- 4.0 min and 5.2 +/- 2.6 min; sustained a hand grip, 7.2 +/- 3.9 min and 6.1 +/- 3.5 min and recalled their name, 8.0 +/- 4.5 min and 6.5 +/- 3.8 min, P > 0.05 ). The recovery of psychomotor function in the elderly took longer compared with the younger patients, and psychomotor function in the elderly recovered at 120 min after the end of propofol infusion. CONCLUSION: Early recovery times following propofol sedation is similar between elderly and younger patients, but recovery of psychomotor function in the elderly is delayed compared with younger patients.

Adult↗