title: [A postoperative syndrome of confusion and stupor or a central anticholinergic syndrome?].
abstract: A case is reported of a 23 year old man who sustained a central anticholinergic syndrome after undergoing upper limb surgery under regional anaesthesia and sedation with 2 mg midazolam and 75 micrograms fentanyl. The disturbances consisted of excitation and inhibition. On the 4th postoperative day, he developed progressive coma, quickly and totally reversed with 2 mg physostigmine. Chronic benzodiazepine therapy seems to be a facilitating factor of central anticholinergic syndrome. The low rate of this postoperative complication seems to proceed from failure to recognize it. Differential diagnosis and place of physostigmine therapy are discussed.
authors.affiliation: Service d'anesthésie-réanimation, Hôpital d'Instruction des Armées Bégin, Saint-Mande.
authors.forename: P M
authors.initials: PM
authors.lastname: Carras
authors.forename: G
authors.initials: G
authors.lastname: Mion
authors.forename: B
authors.initials: B
authors.lastname: Pats
mesh_terms: D000328:Adult; D003128:Coma / Q000209:etiology*; D003221:Confusion / Q000209:etiology*; D006801:Humans; D008297:Male; D010276:Parasympatholytics / Q000009:adverse effects*; D011183:Postoperative Complications; D013577:Syndrome
chemical_list: D010276:Parasympatholytics
vernacular_title: Syndrome confusionnel et stuporeux postopératoire ou syndrome anticholinergique central?