The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.
Using Alcohol as a Standard to Assess the Degree of Impairment Induced by Sedative and Analgesic Drugs Used in Ambulatory Surgery
Open accessAbstract
BACKGROUND: There is a need for a standard by which to compare the degree of subjective and behavioral impairment caused by anesthetic drugs, because anesthesiologists may not be able to gauge how extreme or important a statistically significant change in psychomotor functioning is. This study examined the psychomotor and subjective effects of alcohol at blood concentrations equal or greater than 0.10% as a standard with which to compare those effects caused by sedative and analgesic agents commonly used in ambulatory surgery. METHODS: Twelve healthy human volunteers (11 men and 1 nonpregnant woman), with an average age of 28 yr (range 24-34 yr) and an average alcohol consumption of four drinks per week, were selected in this institutional review board-approved study. Each subject was exposed to five drug conditions (70 mg/70 kg propofol intravenously, 2 mg/70 kg midazolam intravenously, 50 micrograms/70 kg fentanyl intravenously, 0.8 g/kg alcohol orally, and placebo orally and intravenously) in a double-blind randomized fashion over five weekly sessions. Testing was done at baseline and at different intervals until 240 min after drug administration. Testing included psychomotor performance (Maddox Wing, eye-hand coordination, auditory reaction time test, and digit symbol substitution test), subjective effects (strength of drug effect scale, drug liking scale, and visual analog scale), and short-term memory. Psychomotor performance was used as an index of objective impairment, and mood was used as an index of subjective impairment. RESULTS: After consumption of the alcoholic beverage, a blood alcohol level of 0.11 +/- 0.003% (mean +/- SE) was obtained at 15 min after injection. The study drugs not only produced statistically significant impairment (i.e., impairment greater than that seen with placebo) but also, at one or more times after injection, produced impairment similar to that observed with alcohol at a blood alcohol concentration of 0.11%. Midazolam produced a similar degree of impairment to that of alcohol for a longer duration than did fentanyl and propofol. CONCLUSIONS: This study provides evidence that degree of impairment caused by sedative and analgesic drugs used in ambulatory surgery is similar to that obtained with a dose of alcohol that produces a blood alcohol concentration of 0.11%. We suggest that anesthesiologists can use alcohol as a standard by which to assess degree of impairment produced by drugs used for sedation/analgesia.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Different magnitudes of cognitive effect, as measured with the DSST, can be used to make comparative inferences about the relative effects of various doses of agents, such as alcohol, on cognitive performance.
“Different magnitudes of cognitive effect, as measured with the DSST, can be used to make comparative inferences about the relative effects of various doses of agents, such as alcohol, on cognitive performance (Fig. 2).33”
From Digit Symbol Substitution Test: The Case for Sensitivity Over Specificity in Neuropsychological Testing (2018) · cites this paper as [33]
DSST performance was markedly reduced during alcohol intoxication, with scores approximately 10 points lower than placebo.
“Digit Symbol Substitution Test performance was markedly reduced during alcohol intoxication with scores approximately 10 points lower than that of placebo.”
From Digit Symbol Substitution Test: The Case for Sensitivity Over Specificity in Neuropsychological Testing (2018) · cites this paper as [33]
The randomized design of the Thapar et al. study overcomes any confounding from learning or practice effects.
“Although learning or practice effects may occur because the same test is administered multiple times, the randomized design of the study overcomes any resulting confounding factors.”
From Digit Symbol Substitution Test: The Case for Sensitivity Over Specificity in Neuropsychological Testing (2018) · cites this paper as [33]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
SCL-90: an outpatient psychiatric rating scale--preliminary report.
Derogatis, L. R., Lipman, R. S., & Covi, L. (1973) · PubMed · Cited by 3,800
Concreteness, imagery, and meaningfulness values for 925 nouns.
Paivio, A., Yuille, J. C., & Madigan, S. A. (1968) · Journal of Experimental Psychology · doi:10.1037/h0025327 · Cited by 2,855
The Measurement and Appraisal of Adult Intelligence
Webster, A. S., & Wechsler, D. (1958) · The Journal of Criminal Law Criminology and Police Science · doi:10.2307/1141601 · Cited by 1,812
Psychomotor function and psychoactive drugs.
Hindmarch, I. (1980) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1980.tb01745.x · Cited by 519
Measurement of Recovery from Outpatient General Anaesthesia with a Simple Ocular Test
Hannington-Kiff, J. G. (1970) · BMJ · doi:10.1136/bmj.3.5715.132 · Cited by 229
THE EFFECTS OF ALCOHOL AND OTHER DRUGS ON PSYCHOMOTOR PERFORMANCE AND COGNITIVE FUNCTION
Hindmarch, I., Kerr, J. S., & Sherwood, N. (1991) · Alcohol and Alcoholism · doi:10.1093/oxfordjournals.alcalc.a045085 · Cited by 205
Clinical Recovery and Psychomotor Function after Brief Anesthesia with Propofol or Thiopental
Korttila, K. T., Nuotto, E., Lichtor, J. L., Östman, P. L., Apfelbaum, J. L., & Rupani, G. (1992) · Anesthesiology · doi:10.1097/00000542-199205000-00003 · Cited by 89
Self-citationEvaluation of a New Computerized Psychomotor Test Battery: Effects of Alcohol
Nuotto, E., & Korttila, K. T. (1991) · Pharmacology & Toxicology · doi:10.1111/j.1600-0773.1991.tb01253.x · Cited by 76
Effects of acute exposure of toluene and methyl ethyl ketone on psychomotor performance
Dick, R. B., Setzer, J. V., Wait, R., Hayden, M. B., Taylor, B. J., Tolos, B., & Putz‐Anderson, V. (1984) · International Archives of Occupational and Environmental Health · doi:10.1007/bf00378512 · Cited by 72
Subjective and behavioral responses to intravenous fentanyl in healthy volunteers
Zacny, J. P., Lichtor, J. L., Zaragoza, J. G., & de Wit, H. (1992) · Psychopharmacology · doi:10.1007/bf02245155 · Cited by 70
Self-citationAlcohol and marijuana: Comparative dose effect profiles in humans
Heishman, S. J., Stitzer, M. L., & Bigelow, G. E. (1988) · Pharmacology Biochemistry and Behavior · doi:10.1016/0091-3057(88)90244-4 · Cited by 58
Acute behavioural comparisons of toluene and ethanol in human subjects.
Echeverria, D., Fine, L. J., Langolf, G. D., Schork, T., & Sampaio, C. (1991) · Occupational and Environmental Medicine · doi:10.1136/oem.48.11.750 · Cited by 55
Nuotto, E., Korttila, K. T., Lichtor, L., Östman, P. L., & Rupani, G. (1992) · Anesthesia & Analgesia · doi:10.1213/00000539-199202000-00017 · Cited by 54
EFFECTS OF ETHANOL ON PSYCHOMOTOR PERFORMANCE
Fagan, D., Tiplady, B., & SCOTT, D. B. (1987) · British Journal of Anaesthesia · doi:10.1093/bja/59.8.961 · Cited by 41
Comparison of the Sedative Effects of Butorphanol and Midazolam
Dershwitz, M., Rosow, C. E., Biase, P. M. D., & Zaslavsky, A. M. (1991) · Anesthesiology · doi:10.1097/00000542-199104000-00016 · Cited by 41
Klein, K. E. (1972) · PubMed · Cited by 16
Flagged first, then by citations
Research works printed but not linked: 2
- [1]1. Ostman PL, White PF: Outpatient anesthesia, Anesthesia. 4th edition. Edited by Miller RD. New York, Churchill-Livingstone, 1994,
- [24]24. Manual of Mental Disorders. 3rd edition (revised). Washington, D.C., American Psychiatric Association, 1987
Cited by
Sorted by citations
Jaeger, J. (2018) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000941 · Cited by 836
A Comparison of the Cell Phone Driver and the Drunk Driver
Strayer, D. L., Drews, F. A., & Crouch, D. J. (2006) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1518/001872006777724471 · Cited by 578
Quantifying the performance impairment associated with fatigue
Lamond, N., & Dawson, D. E. (1999) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1999.00167.x · Cited by 238
Larsen, B., Seitz, A., & Larsen, R. (2000) · Anesthesia & Analgesia · doi:10.1097/00000539-200001000-00035 · Cited by 172
Padmanabhan, U., Leslie, K., Eer, A., Maruff, P. T., & SILBERT, B. S. (2009) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e3181a6ad31 · Cited by 100
Driving Ability Under Long-Term Treatment with Transdermal Fentanyl
Sabatowski, R., Schwalen, S., Rettig, K., Herberg, K. W., Sm, K., & Radbruch, L. (2003) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(02)00539-0 · Cited by 93
Riphaus, A., Wehrmann, T., Hausmann, J., Weber, A., von Delius, S., Jung, M., Tonner, P. H., Arnold, J., Behrens, A., Beilenhoff, U., et al. (2015) · Zeitschrift für Gastroenterologie · doi:10.1055/s-0035-1553971 · Cited by 83
S3 Guideline: Sedation for gastrointestinal endoscopy 2008
Riphaus, A., Wehrmann, T., Weber, A., Arnold, J., Beilenhoff, U., Bitter, H., von Delius, S., Domagk, D., Ehlers, A., Faiss, S., et al. (2009) · Endoscopy · doi:10.1055/s-0029-1215035 · Cited by 74
Blood alcohol concentration and psychomotor effects
Grant, S. A., Millar, K., & Kenny, G. N. C. (2000) · British Journal of Anaesthesia · doi:10.1093/bja/85.3.401 · Cited by 64
Breitmeier, D., Seeland, I., Hecker, H., & Schneider, U. (2007) · Addiction Biology · doi:10.1111/j.1369-1600.2007.00056.x · Cited by 61
Information Loss over Time Defines the Memory Defect of Propofol
Veselis, R. A., Reinsel, R. A., Feshchenko, V. A., & Johnson, R. (2004) · Anesthesiology · doi:10.1097/00000542-200410000-00006 · Cited by 61
Richardson, M. G., Wu, C. L., & Hussain, A. (1997) · Anesthesia & Analgesia · doi:10.1097/00000539-199708000-00011 · Cited by 59
Elmenhorst, D., Elmenhorst, E., Luks, N., Maass, H., Mueller, E.-W., Vejvoda, M., Wenzel, J., & Samel, A. (2008) · Sleep Medicine · doi:10.1016/j.sleep.2007.12.003 · Cited by 57
Gaertner, J., Radbruch, L., Giesecke, T., Gerbershagen, H. U., Petzke, F. W., Ostgathe, C., Elsner, F., & Sabatowski, R. (2006) · Acta Anaesthesiologica Scandinavica · doi:10.1111/j.1399-6576.2006.01027.x · Cited by 54
Li, H. K., Abouleish, A. E., Grady, J. J., Groeschel, W., & Gill, K. S. (2000) · Ophthalmology · doi:10.1016/s0161-6420(99)00009-3 · Cited by 54
Behavioral and Physiological Effects of Remifentanil and Alfentanil in Healthy Volunteers
Black, M. L., Hill, J. L., & Zacny, J. P. (1999) · Anesthesiology · doi:10.1097/00000542-199903000-00013 · Cited by 48
Self-citationDagtekin, O., Gerbershagen, H. J., Wagner, W., Petzke, F., Radbruch, L., & Sabatowski, R. (2007) · Anesthesia & Analgesia · doi:10.1213/01.ane.0000281078.65585.1e · Cited by 47
Car Accidents After Ambulatory Surgery in Patients Without an Escort
Chung, F. F., & Assmann, N. (2008) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e3181609531 · Cited by 47
Shmygalev, S., Damm, M., Weckbecker, K., Berghaus, G., Petzke, F. W., & Sabatowski, R. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.01.017 · Cited by 42
Zacny, J. P., & Gutiérrez, S. (2011) · Psychopharmacology · doi:10.1007/s00213-011-2349-6 · Cited by 42
Self-citationWehrmann, T., Riphaus, A., Eckardt, A. J., Klare, P., Kopp, I., von Delius, S., Rosien, U., Tonner, P. H., & Collaborators (2023) · Zeitschrift für Gastroenterologie · doi:10.1055/a-2165-6388 · Cited by 28
García‐Gea, C., Martínez, J., Ballester, M. R., Gich, I. J., Valiente, R., & Antonijoan, R. M. (2014) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2378 · Cited by 27
Effects of Fentanyl and Low Doses of Alcohol on Neuropsychological Performance in Healthy Subjects
Schneider, U., Bevilacqua, C., Jacobs, R., Karst, M., Dietrich, D. E., Becker, H., Müller‐Vahl, K., Seeland, I., Gielsdorf, D., Schedlowski, M., et al. (1999) · Neuropsychobiology · doi:10.1159/000026558 · Cited by 26
Wehrmann, T., Riphaus, A., Eckardt, A. J., Klare, P., Kopp, I., von Delius, S., Rosien, U., Tonner, P. H., & Collaborators (2023) · Zeitschrift für Gastroenterologie · doi:10.1055/a-2124-5333 · Cited by 25
Theodorou, T., Hales, P., Gillespie, P. E., & Robertson, B. (2001) · Anaesthesia and Intensive Care · doi:10.1177/0310057x0102900206 · Cited by 25
A system for psychomotor evaluation; design, implementation and practice effects in volunteers
Hope, A., Woolman, P. S., Gray, W. M., Asbury, A. J., & Millar, K. (1998) · Anaesthesia · doi:10.1046/j.1365-2044.1998.00434.x · Cited by 23
Assessing Cognitive and Psychomotor Performance in Patients with Fibromyalgia Syndrome
Shmygalev, S., Dagtekin, O., Gerbershagen, H. U., Marcus, H. E., Jübner, M., Sabatowski, R., & Petzke, F. W. (2014) · Pain and Therapy · doi:10.1007/s40122-014-0028-0 · Cited by 22
Severity and duration of mental deficiency symptoms after intravenous administration of propofol
Seidl, S., Hausmann, R., Neisser, J., Janisch, H. D., & Betz, P. (2006) · International Journal of Legal Medicine · doi:10.1007/s00414-006-0109-7 · Cited by 14
Use of the Psychomotor Vigilance Test in Fitness for Work Assessments
Lerman, S., Mollicone, D. J., & Coats, S. (2017) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001065 · Cited by 8
Schnabel, E. (2011) · Cited by 8
Forget me not: The effect of doxycycline on human declarative memory
Wehrli, J. M., Xia, Y., Meister, L., Tursunova, S., Kleim, B., Bach, D. R., & Quednow, B. B. (2024) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2024.08.006 · Cited by 6
Cheng, C. W. N. (2003) · Ambulatory Surgery · doi:10.1016/s0966-6532(02)00044-6 · Cited by 4
Riphaus, A., Wehrmann, T., Weber, A., Arnold, J., Beilenhoff, U., Bitter, H., von Delius, S., Domagk, D., Ehlers, A., Faiss, S., et al. (2008) · Cited by 4
Ayandeh, A., Farrell, N. M., & Sheng, A. Y. (2023) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2023.05.010 · Cited by 3
Riphaus, A., Wehrmann, T., Hausmann, J., Weber, A., von Delius, S., Jung, M. K., Arnold, J., Behrens, A., Seifert, H., & Wappler, F. (2016) · Cited by 3
Alcohol, auditory functioning and deafness
CRAWFORD, A. (1997) · Addiction Biology · doi:10.1080/13556219772688 · Cited by 3
Sensitivity of S-Cat to Sleep Deprivation
French, J., Neville, K., Eddy, D. R., Storm, W. F., Cardenas, R., Flynn, C., & Miller, J. C. (2006) · doi:10.21236/ada444715 · Cited by 2
Li, H. K., & Abouleish, A. E. (2002) · Ophthalmology · doi:10.1016/s0161-6420(01)01052-1 · Cited by 2
Cognitive functions of patients treated with chemotherapy: A comparative study
Khalil, R. B., Haddad, F., Cordahi, C. C., Fiani, D., Moukarzel, J.-M., Chamoun, Y., Kourié, H. R., Richa, S., & Kattan, J. G. (2023) · L Encéphale · doi:10.1016/j.encep.2023.10.001 · Cited by 1
Use of Computerized Neurocognitive Assessment Software for the Detection of Alcohol IntoxicationPreprint
Janarthanan, S. R., Phi, H. Q., Flores, B., Katz, Y., Eagleman, D. M., Huang, B., & Ghomi, R. H. (2020) · medRxiv · doi:10.1101/2020.05.12.20086868 · Cited by 1
Non-Human Primate Model for Performance Effects of Ethanol
Blick, D. W., Weathersby, F. R., Jr., M., Cosgrove Stephanie, A., Murphy Donald, J., & Michael, R. P. (2000) · doi:10.21236/ada386654
Potencial de abuso do midazolam intranasal em usuários de cocaína aspirada e voluntários normais
Braun, I. M. (2012) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2012.tde-28112012-124456
Pharmacodynamics: Effects of Abused Drugs on Human Performance
Myers, C. S., & Heishman, S. J. (2007) · CRC Press eBooks · doi:10.1201/9781420054606.ch5
Heishman, S. J. (2006) · CRC Press eBooks · doi:10.1201/9781420003468.ch4
Case 17: An Ambulatory Surgical Patient with No Escort
Brock‐Utne, J. G. (2011) · Springer eBooks · doi:10.1007/978-1-4419-1179-7_17
Autorinnen/Autoren, & Coautoren (2026) · Zeitschrift für Gastroenterologie · doi:10.1055/a-2822-0157
Metadata
- Authors
- Thapar, P., Zacny, J. P., Thompson, W., & Apfelbaum, J. L.
- Affiliations
- University of Chicago (US)
- Venue
- Anesthesiology
- Published
- 1995-01-01
- Volume
- 82
- Issue
- 1
- Pages
- 53-59
- ISSN
- 0003-3022 (ISSN-L)
- OpenAlex
- W1996013809
- Cited by
- 47
- References
- 16
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 5 · 2020: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 2 · 2012: 1
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Anesthesiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Life Sciences › Neuroscience › Developmental Neuroscience › Anesthesia and Neurotoxicity Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Keywords
- outpatient surgery, sedatives, analgesics, propofol, midazolam, fentanyl, psychomotor performance, blood alcohol concentration, short-term memory, mood, eye-hand coordination, reaction time, Digit Symbol Substitution Test
- MeSH terms
- Administration, Oral, Adult, Ethanol, Ambulatory Surgical Procedures, Double-Blind Method, Female, Fentanyl, Hemodynamics, Humans, Injections, Intravenous, Male, Memory, Short-Term, Midazolam, Prospective Studies, Psychomotor Performance, Reference Standards, Propofol
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
