Korean J Anesthesiol.  1995 Dec;29(6):830-835. 10.4097/kjae.1995.29.6.830.

The Effect of Physostigmine on Arousal and Respiration after General Anesthesia with Enflurane

• Lim JJ
• Um DJ
• Nam YT
• Kim SY

• KMID: 2090939
• DOI: http://doi.org/10.4097/kjae.1995.29.6.830

Abstract

Physostigmine has been used to counteract somnolence or coma induced by different types of pharmacological agent, such as anticholinergics, opioids, ketamine, tricyclic antidepressants and inhalational anesthetics. In this study, we have assessed the effect of physostigmine on arousal and respiration after 50% N2O-50% O2-enflurane general anesthesia under controlled condition such as no premedication, no neuromuscular blockade, same operative procedure and duration. Fifty healthy gynecologic patients scheduled for dilatation & curettage and cervical cone biopsy were divided randomly into two groups such as control group and physostigmine group. In physostigmine group, 0.02 mg/kg of physostigmine was administered intravenously at the end of operation. We evaluated the recovery time of pain response, eye opening on verbal command and orientation after the end of operation. We also checked the end-tidal enflurane concentration with SARACAP spectrometry. Blood pressure, pulse rate, respiration rate and tidal volume were checked at the end of operation and at the time of each recovery parameters returned. The results were as follows; first, pain response time was 5.1+/-2.4 min in control group compared with 3.5+/-2.1 min in physostigmine group. Second, on simple order to patients, eye opening time was 8.5+/-2.3 min in control group compared with 6.5+/-2.1 min in physostigmine group. Third, recovery of orientation to time, place and person was 9.7+/-2.8 min in control group compared with 7.5+/-2.1 min in physostigmine group. Fourth, there was no significant difference in respiratory parameters between the two groups. But there was no significant difference in end-tidal enflurane concentration between the two groups inspite of rapid recovery time in physostigmine group. In conclusion, 0.02mg/kg of physostigmine has the effect of early arousal after enflurane anesthesia without specific problems.

Keyword

Physostigmine; Enflurane; Arousal; Respiration

MeSH Terms

Analgesics, Opioid
Anesthesia
Anesthesia, General*
Anesthetics
Antidepressive Agents, Tricyclic
Arousal*
Biopsy
Blood Pressure
Cholinergic Antagonists
Coma
Dilatation and Curettage
Enflurane*
Female
Heart Rate
Humans
Ketamine
Neuromuscular Blockade
Physostigmine*
Premedication
Reaction Time
Respiration*
Respiratory Rate
Spectrum Analysis
Surgical Procedures, Operative
Tidal Volume
Analgesics, Opioid
Anesthetics
Antidepressive Agents, Tricyclic
Cholinergic Antagonists
Enflurane
Ketamine
Physostigmine