Evaluation of a Computer Program Designed to Assess Psychomotor Recovery after Day Care Anesthesia-Comparison with Clinical Criteria

Abstract

Background and aims: Day care surgery under general anesthesia offers a number of advantages to patients, health care providers and hospitals. A software program "Computer Aided Psychomotor" (CAP) test was designed by one of the authors for objective evaluation of cognitive and affective domains in patients recovering from anesthesia. Method: The CAP test was evaluated in 40 adult patients of ASA I or II recovering from general anesthesia after day care surgical procedures. Balanced anesthesia technique was administered to all the patients. A series of ten response time (RT) to the CAP test were recorded in the PAC, in the immediate preoperative period and at 30, 60, 90, 120, 180 and 240 minutes in the postoperative period. For comparison, recovery was also assessed by a clinical recovery score (CRS) at the same time interval. Result: Hierarchical ANOVA (F-test) was used to determine significance of difference between the observations recorded by CAP test and by the clinical method. At each time point, Dunnett's test was applied for comparison. Paired t–test was used for comparison of the two methods. The trends of recovery by the two methods of assessment were similar. However, at one hour and beyond in the recovery period, the CAP test was about 10% more sensitive than the clinical method. At 120, 180 and 240 minutes, the CAP test was able to detect an apparent state of "supernormal" recovery which was not detectable by clinical method. Conclusion: The CAP test is an alternate method for assessment of recovery of psychomotor skills after day care anesthesia. It is a simple bedside test that can be performed in patients recovering from anesthesia. The CAP test is an objective assessment as against high level of subjective bias that could occur with the clinical method of assessment.