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Computerized 4-choice reaction time test for the measurement of psychomotor recovery after general anesthesia

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Abstract

The recovery of patients after general anesthesia is usually estimated by using clinical scores. Since there is a lack of objective methods for assessing psychomotor recovery, the aim of this study was to evaluate three psychological tests for this purpose. Patients, scheduled for ambulatory gynecological surgery, underwent 3 standard psychological tests before (T1), 15 min after the surgery (T2) and on discharge from the recovery room (T3). The tests used were Wechsler memory scale (test 1, working memory capacity), d2—test (test 2, concentration endurance) and computer-based 4-choice-reaction time (4CRT, test 3, reaction time) as well as Postanesthesia Discharge Scoring System (PADSS). The same test battery was used in healthy female volunteers, all test results were compared at the different time points. In 109 patients, working memory capacity and concentration (tests 1 and 2) decreased, the reaction time (test 3) was prolonged at T2 in comparison with T1 and T3 (P < 0.01). PADSS increased from 8 (T2) to 10 (T3) (medians, P < 0.001). Fifty-seven healthy volunteers demonstrated a practice effect in all 3 tests through the course of the study (P <0.01). 4CRT test had shortest duration and enabled computerized data processing. All three tests objectively assess the recovery of psychomotor function in patients after general anesthesia, the computer-based 4CRT seems to be the most convenient for the clinical routine.

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Acknowledgements

The authors thank Maria Gagarine for re-checking of the manuscript for mistakes, the patients and the volunteers who took part in this investigation as well as the anesthetic nurses who helped to conduct the investigation.

Funding

Departmental funding only.

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    Authors and Affiliations

    1. Department of Anesthesiology, University Medicine of Greifswald, Sauerbruchstrasse, 17475, Greifswald, Germany

      Taras I. Usichenko, Danika Städing, Henriette Janner & Thomas Hesse

    2. Department of Anesthesia, McMaster University, Hamilton, Canada

      Taras I. Usichenko

    3. Department of Internal Medicine, University Medicine of Greifswald, Greifswald, Germany

      Michael Boesche

    4. Hasso Plattner Institute, University of Potsdam, Potsdam, Germany

      Robert Lehmann

    5. Department of Anesthesia, Dalhousie University, Halifax, Canada

      Dragan Pavlovic

    6. Department of Anesthesiology and Intensive Care Medicine, Emergency Medicine and Pain Management, Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany

      Andreas Nowak

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    1. Taras I. Usichenko
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    Correspondence to Taras I. Usichenko.

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    Taras I. Usichenko and Danika Städing have contributed equally to this work.

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    10877_2019_355_MOESM1_ESM.pptx

    Supplementary material 1 (PPTX 1295 kb) Supplementary figure. Laptop with the DOS-based software with four-choice-reaction-time (4CRT) test. One out of 4 possible digits is displayed on the screen of the laptop; the response unit connected to the laptop with the buttons 1-4 is seen on the right side.

    Supplementary material 2 (DOCX 72 kb)

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    Usichenko, T.I., Städing, D., Boesche, M. et al. Computerized 4-choice reaction time test for the measurement of psychomotor recovery after general anesthesia. J Clin Monit Comput 34, 833–841 (2020). https://doi.org/10.1007/s10877-019-00355-3

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    • DOI: https://doi.org/10.1007/s10877-019-00355-3

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