title: Physostigmine: going ... going ... gone? Two cases of central anticholinergic syndrome following anaesthesia and its treatment with physostigmine.
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.
authors.affiliation: Department of Anaesthesia, St Bartholomew's Hospital, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Martin
authors.forename: P R
authors.initials: PR
authors.lastname: Howell
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000009:adverse effects*; D001784:Blood Gas Analysis; D018678:Cholinergic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007431:Intraoperative Complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects*; D010830:Physostigmine / Q000008:administration & dosage / Q000627:therapeutic use*; D012601:Scopolamine / Q000009:adverse effects*
chemical_list: D018678:Cholinergic Agents; D018727:Muscarinic Antagonists; D010830:Physostigmine; D012601:Scopolamine