The purpose of this prospective study was to identify the incidence of a distinct central anticholinergic syndrome following routine anaesthesia. For 2 months, all inpatients aged more than 15 years scheduled for elective procedures and cared for in the recovery room were investigated for symptoms of the syndrome. Patients with neuropsychiatric disease or other disorders that could alter consciousness were excluded. Prolonged action of anaesthetics or relaxants, respiratory depression and metabolic disorder were ruled out before making the diagnosis. Out of 962 patients (366 men, 596 women), 18 (4 men, 14 women) developed the syndrome. The difference between men and women was not statistically significant. Six out of 60 women developed the syndrome after a hysterectomy with or without adnectomy/oophorectomy, and this high incidence was significantly different from that observed after all other procedures in women (P = 0.003) or all other gynaecological procedures (P = 0.013). The reason for this is unknown. In six of the 18 cases, untreated prolonged somnolence lasted for more than 2 h. All patients woke up after an injection of physostigmine, but six of them relapsed into somnolence and needed a second, and in one case a third, injection. The findings of the study emphasize that, when there is delayed recovery from anaesthesia, the diagnosis of central anticholinergic syndrome should be considered if other accessible causes for that condition have been excluded.
In this double-blind, randomized study, we have investigated 100 healthy children, aged 3-6 yr. We compared intubating conditions and cardiovascular changes during light halothane anaesthesia and propofol 3 mg kg-1 with those during deep halothane anaesthesia. Light halothane anaesthesia was defined as an end-tidal concentration of 1%, deep halothane anaesthesia as 2%. Intubating conditions were graded according to ease of laryngoscopy, vocal cord position and coughing. There were no statistically significant differences in the assessment of intubating conditions between the two groups; 94% of the children in the 1% halothane-propofol group and 100% of the children in the 2% halothane group had acceptable intubating conditions. Systolic arterial pressure decreased by 13% in the 1% halothane-propofol group compared with 20% in the 2% halothane group (P < 0.01).
Recent studies have demonstrated that intranasal is comparable to intravenous opioid titration in its pain 30, 150 d 330, 420 480 et ~ 540 ~ 600 min (P <0,05). La dose de mdp~ridine nasale requise a ~t~ de 112,9 + 81,3 rag, et la mdp$ridine souscutan~e de 103,4 5:41,5 mg (NS) Opioid administration is the most common form of postoperative pain management I and should be performed CAN J ANAESTH 1995 / 42:4 / pp 287-91
Distinct central anticholinergic syndrome following general anaesthesia Summary ectomy, and this high incidence was significantly different from that observed after all other procedures The purpose of this prospective study was to identify in women (P=0.003) or all other gynaecological prothe incidence of a distinct central anticholinergic syncedures (P=0.013). The reason for this is unknown. drome following routine anaesthesia. For 2 months, In six of the 18 cases, untreated prolonged somnolence all inpatients aged more than 15 years scheduled for lasted for more than 2 h. All patients woke up after an elective procedures and cared for in the recovery room injection of physostigmine, but six of them relapsed were investigated for symptoms of the syndrome.into somnolence and needed a second, and in one Patients with neuropsychiatric disease or other discase a third, injection. The findings of the study emorders that could alter consciousness were excluded. phasize that, when there is delayed recovery from Prolonged action of anaesthetics or relaxants, resanaesthesia, the diagnosis of central anticholinergic piratory depression and metabolic disorder were ruled syndrome should be considered if other accessible out before making the diagnosis. Out of 962 patients causes for that condition have been excluded. (366 men, 596 women), 18 (4 men, 14 women) developed the syndrome. The difference between men Keywords: central anticholinergic syndrome, inand women was not statistically significant. Six out cidence, general anaesthesia; physostigmine. of 60 women developed the syndrome after a hysterectomy with or without adnectomy/oophor-
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