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  • Title: Physostigmine: going ... going ... gone? Two cases of central anticholinergic syndrome following anaesthesia and its treatment with physostigmine.
    Author: Martin B, Howell PR.
    Journal: Eur J Anaesthesiol; 1997 Jul; 14(4):467-70. PubMed ID: 9253580.
    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.
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