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A postoperative syndrome of confusion and stupor or a central anticholinergic syndrome?

A postoperative syndrome of confusion and stupor or a central anticholinergic syndrome?

Cahiers d'Anesthesiologie 40(3): 212-213

A case is reported of a 23 year old man who sustained a central anticholinergic syndrome after undergoing upper limb surgery under regional anaesthesia and sedation with 2 mg midazolam and 75 micrograms fentanyl. The disturbances consisted of excitation and inhibition. On the 4th postoperative day, he developed progressive coma, quickly and totally reversed with 2 mg physostigmine. Chronic benzodiazepine therapy seems to be a facilitating factor of central anticholinergic syndrome. The low rate of this postoperative complication seems to proceed from failure to recognize it. Differential diagnosis and place of physostigmine therapy are discussed.

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Accession: 039098827

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PMID: 1515962

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