Modafinil improves recovery after general anesthesia.

CRNA*From the Departments of *Anesthesiology and †Psychiatry, University of Medicine and Dentistry of New Jersey, CooperHealth System, Camden, New Jersey, and the ‡Center for Research in Medical Education, Jefferson Medical College,Thomas Jefferson University, Philadelphia, PennsylvaniaRecovery from general anesthesia often involves resid-ual sedation, drowsiness, fatigue, and lack of energythatmaylasthourstodays.Modafinilisawakefulness-promoting drug approved for patients with excessivedaytime sleepiness associated with narcolepsy. Weevaluated the effect of single doses of modafinil(200 mg) and placebo in patients recovering from gen-eral anesthesia. Thirty-four subjects participated in thisprospective, randomized, double-blind study ap-provedbyourIRB.Preoperatively,patientswereaskedto rate various symptoms they had experienced overthe previous 24-h using a verbal analog scale (VAS) of 0to 10 as well as discrete scale when indicated. Postoper-atively, once the patient was able to tolerate oral intakeand met our institutional discharge criteria, the studydrug (modafinil 200 mg or placebo) was administeredwithasipofwater.Patientswerecontacted24(1)hoursafter dosing to evaluate postdischarge symptoms. Pa-tients in the placebo group reported significantly morepostoperativefatigue(4.8[3.3]versus1.4[1.8]),exhaus-tion (4.3 [3.3] versus 2.4 [3.1]), or degree of feeling wornout (4.7 [3.6] versus 2.9 [2.4]). Significantly more pa-tients reported moderate to severe fatigue in the pla-cebo group (65% versus 12%). Two major themes of“alertness” and “energy” were expressed by 71% of thepatientsreceivingmodafinilversus18%ofthosereceiv-ing placebo. Patients recovering from general anesthe-sia can significantly benefit from modafinil.(Anesth Analg 2004;98:976–81)