General anesthesia for interventional neuroradiology: Propofol versus isoflurane

Study Objective: To compare recovery of psychomotor and cognitive ability after isoflurane and propofol-based general anesthesia. Design: Prospective, blinded interventional study. Setting: University hospital. Patients: 24 ASA physical status I and II patients undergoing embolization procedures for intracranial vascular lesions. Interventions: Isoflurane anesthesia or propofol anesthesia was given to patients. Measurements: Awakening time; early recovery (5 minutes, 15 minutes, 30 minutes) was assessed using orientation and Steward tests; medium recovery (30 minutes, 60 minutes, 120 minutes) was tested using Controlled World Association (COWAT) and Digit Span tests; late recovery (4 hours, 24 hours) was assessed using a Verbal Learning and Memory Test and three subtests of a computerized attention test battery. Main Results: Awakening time and early recovery of motor and respiratory function did not differ between groups. The propofol group scored worse in COWAT and Digit Span tests up to 60 minutes after anesthesia. Both groups showed an impairment of higher cognitive functions up to 24 hours after anesthesia. Conclusions: Both isoflurane- and propofol-based anesthesia allow early extubation and recovery of basic psychomotor functions. More sophisticated tests show a decline of cognitive functions up to 24 hours after isoflurane- as well as propofol-based anesthesia. Because both anesthetics show similar recovery of psychomotor functions after long duration anesthesia, other factors such as subjective well-being and costs may be considered when deciding between these two anesthetics.