Failure to recover after anaesthesia assigned to a transient dissociative state

Failure of a patient to recover rapidly after anaesthesia is a rare event, due to various causes, including medication related effects, metabolic dist urbances or neurologic insults. We report a case in a middle aged physicall y healthy woman who failed to recover promptly after intravenous anaesthesi a. Propofol was administered for 20 minutes. Results of neurologic assessme nt were normal, as were laboratory tests and CT-scan. Four hours after comp letion of the anaesthesia, return to consciousness occurred spontaneously. The patient had a history of depressive symptoms. However the psychiatric a ssess ment was unremarkable. We hypothesise that she developed a transient dissociative disorder. (C) 2000 Editions scientifiques et medicales Elsevie r SAS.