PHYSOSTIGMINE - GOING ... GOING ... GONE - 2 CASES OF CENTRAL ANTICHOLINERGIC SYNDROME FOLLOWING ANESTHESIA AND ITS TREATMENT WITH PHYSOSTIGMINE

Two patients presented with very different signs of central anticholin ergic syndrome following general anaesthesia for which they had receiv ed 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 anticholinergi c syndrome is multi-factorial, but the diagnosis should be considered in all patients who demonstrate abnormal post-anaesthetic awakening. I t is recommended that 1 mg of intravenous physostigmine is a safe and effective treatment for central anticholinergic syndrome, and that a s upply of this important drug must be kept readily available in the rec overy area of the operating theatre department.