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Physostigmine: going … going … gone? Two cases of central anticholinergic syndrome following anaesthesia and its treatment with physostigmine

Published online by Cambridge University Press:  16 August 2006

B. Martin
Affiliation:
Department of Anaesthesia, St Bartholomew's Hospital, London EC1A 7BE, UK
P. R. Howell
Affiliation:
Department of Anaesthesia, St Bartholomew's Hospital, London EC1A 7BE, UK
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Abstract

Two patients presented with very different signs of central anticholinergic syndrome following general anaesthesia for which they had received premedication with hyoscine. Both responded dramatically to 1 mg of intravenous (i.v.) physostigmine, which produced a rapid return to a normal level of consciousness. The aetiology of central anticholinergic syndrome is multi-factorial, but the diagnosis should be considered in all patients who demonstrate abnormal post-anaesthetic awakening. It is recommended that 1 mg of intravenous physostigmine is a safe and effective treatment for central anticholinergic syndrome, and that a supply of this important drug must be kept readily available in the recovery area of the operating theatre department.

Type
Case Report
Copyright
1997 European Society of Anaesthesiology

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