title: Anesthesia with 1.5 minimum alveolar concentration sevoflurane is not altered by physostigmine as measured by bispectral and clinical indices.
abstract: OBJECTIVE
  To evaluate the effect of physostigmine on 1.5% sevoflurane anesthesia and recovery.
  
  
  METHODS
  Prospective, randomized, double-blinded study.
  
  
  METHODS
  Operating room of a university-affiliated, metropolitan hospital (Aretaieion Hospital and St Savas Hospital).
  
  
  METHODS
  Forty female American Society of Anesthesiologists physical status I and II patients scheduled for breast biopsy.
  
  
  METHODS
  Patients were randomly assigned in physostigmine (PHYSO) and normal-saline (NS) group. Anesthesia was induced with sevoflurane 8% using a vital capacity breath technique, and rocuronium 0.6 mg/kg was given to facilitate Laryngeal Mask Airway (LMA) No. 4 insertion. Anesthesia was maintained with end-tidal sevoflurane 1.5 minimum alveolar concentration (MAC; 3% end-tidal concentration) throughout the procedure.
  
  
  METHODS
  After skin closure and under steady-state sevoflurane anesthesia 1.5 MAC, heart rate, blood pressure, and Bispectral Index (BIS) were recorded. Immediately after, the PHYSO group received intravenous 2 mg of physostigmine, whereas the NS group received equal volume of normal saline. Bispectral Index and hemodynamic measurements were recorded 5, 8, and 10 minutes after treatment. Anesthesia was then discontinued and the LMA was removed. Zero, 15, and 30 minutes after LMA removal, patients were evaluated for orientation, sedation, sitting ability, and the "picking up matches" test, as well as for nausea and vomiting.
  
  
  RESULTS
  No difference was found in BIS (29 +/- 4, 32 +/- 6, 31 +/- 6, 30 +/- 7, 84 +/- 11 in the PHYSO group vs 29 +/- 6, 30 +/- 6, 30 +/- 5, 31 +/- 5, 86 +/- 7 in the NS group), hemodynamic parameters, or recovery parameters between the 2 groups at any time. No nausea or vomiting was observed in either group.
  
  
  CONCLUSIONS
  Physostigmine did not influence BIS values or early recovery when administered to patients anesthetized with 1.5 MAC sevoflurane anesthesia.
authors.affiliation: Department of Anesthesiology, Aretaieion Hospital, Medical School University of Athens, 11528 Athens, Greece.
authors.forename: Anteia
authors.initials: A
authors.lastname: Paraskeva
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Staikou
authors.forename: Morphis
authors.initials: M
authors.lastname: Diamadis
authors.forename: Ioanna
authors.initials: I
authors.lastname: Siafaka
authors.forename: Argyro
authors.initials: A
authors.lastname: Fassoulaki
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002800:Cholinesterase Inhibitors / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004569:Electroencephalography / Q000187:drug effects / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D017214:Laryngeal Masks; D008738:Methyl Ethers / Q000008:administration & dosage*; D010830:Physostigmine / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D002800:Cholinesterase Inhibitors; D008738:Methyl Ethers; D000077149:Sevoflurane; D012965:Sodium Chloride; D010830:Physostigmine