Sevoflurane as a single anesthetic and physostigmine failure to enhance arousal.
OBJECTIVE
Sevoflurane is recommended for inhalational induction of anesthesia. Physostigmine may antagonize general anesthetics. The study investigates sevoflurane as a single anesthetic and its possible antagonism by physostigmine.


METHODS
In 60 women scheduled for breast lump excision, anesthesia was induced with 8% sevoflurane. After 3 min of sevoflurane inhalation, a laryngeal mask airway (LMA) was inserted. Anesthesia was maintained with spontaneous ventilation at end tidal sevoflurane 3%. Systolic and diastolic blood pressure, heart rate and end tidal CO(2) were recorded intraoperatively. After skin closure and at end tidal sevoflurane 0.9%, physostigmine 2 mg or normal saline was given. After 2 min systolic, diastolic blood pressure, heart rate and end tidal CO(2) were recorded and sevoflurane was discontinued. Time to eyes opening, LMA removal and verbal response was recorded. Patients were also assessed for orientation, sedation, sitting ability and the ''picking up matches'' test at 0, 15 and 30 min after LMA removal.


RESULTS
Systolic, diastolic blood pressure and heart rate increased after laryngeal mask placement (P=0.0001, P=0.0001 and P=0.0001, respectively). Orientation, sitting ability and ''picking up'' matches were similar in the 2 groups. Sedation at 15 min was less in the control group (P=0.004).


CONCLUSIONS
Sevoflurane can be used as a single anesthetic but its recovery is not enhanced by physostigmine.
Paraskeva
A
A
Anesthesiology Unit, Aretaieion Hospital, Athens, Greece. aparask@med.uoa.gr
Petropoulos
G
G
Siafaka
I
I
Fassoulaki
A
A
D018685:Anesthetics, Inhalation; D000931:Antidotes / Q000627:therapeutic use*; D001143:Arousal / Q000187:drug effects*; D001706:Biopsy; D001794:Blood Pressure / Q000187:drug effects; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008738:Methyl Ethers; D010830:Physostigmine / Q000627:therapeutic use*; D015656:Respiratory Mechanics / Q000187:drug effects; D000077149:Sevoflurane; D017211:Treatment Failure
D018685:Anesthetics, Inhalation; D000931:Antidotes; D008738:Methyl Ethers; D000077149:Sevoflurane; D010830:Physostigmine