title: [Silexan and narcosis : case report and possibilities of preoperative and perioperative management].
abstract: The increased use of phytotherapeutic drugs means that anesthetists are more often confronted with these drugs. In this case report possible problems which can occur are demonstrated exemplified by silexan. Silexan is a phytotherapeutic anxiolytic which is used in anxiety disorders. Because of its potential mechanism of action via the neurotransmitter gamma-aminobutyric acid (GABA) receptors interactions with narcotic drugs are possible. The case of an 18-year-old girl who underwent an operation under general anesthesia while taking silexan as long-term medication is presented. The desired depth of narcosis could only be reached by inhalative induction with sevoflurane after unsuccessful induction attempts using intravenous propofol and thiopental. Possible explanations for this route and inhalative induction as a possible alternative are discussed.
authors: Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Deutschland. sebastian.decker@med.uni-heidelberg.de
authors: S O
authors: SO
authors: Decker
authors: H
authors: H
authors: Polarz
mesh_terms: D000293:Adolescent; D000771:Anesthesia, Intravenous; D000777:Anesthetics / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D016080:Arachnoid Cysts / Q000601:surgery; D002526:Cerebellar Diseases / Q000601:surgery; D004347:Drug Interactions; D005260:Female; D018756:GABA Antagonists / Q000009:adverse effects; D006801:Humans; D006993:Hypnotics and Sedatives; D007275:Injections, Intravenous; D027523:Lavandula; D019635:Neurosurgical Procedures; D009765:Obesity / Q000150:complications; D009822:Oils, Volatile / Q000009:adverse effects*; D010938:Plant Oils / Q000009:adverse effects*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D015742:Propofol / Q000009:adverse effects; D011963:Receptors, GABA-A / Q000187:drug effects; D013874:Thiopental
chemical_list: D000777:Anesthetics; D018686:Anesthetics, Intravenous; D018756:GABA Antagonists; D006993:Hypnotics and Sedatives; D009822:Oils, Volatile; D010938:Plant Oils; D011963:Receptors, GABA-A; D013874:Thiopental; D015742:Propofol; C045718:lavender oil