Central anticholinergic syndrome following general anaesthesia: prevention and treatment with galantamine
- Authors: Danilov M.S.1, Lebedinskii K.M.1, Kurapeev I.S.1
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Affiliations:
- North-Western State Medical University names after I.I. Mechnikov
- Issue: Vol 10, No 1 (2018)
- Pages: 43-48
- Section: Reviews
- URL: https://journal-vniispk.ru/vszgmu/article/view/8811
- DOI: https://doi.org/10.17816/mechnikov201810143-48
- ID: 8811
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Abstract
Prolonged emergence, excitation and shivering after general anaesthesia are well-known, though only in German-speaking countries they are considered to be forms of single central anticholinergic syndrome (CAS), while in others this term is not associated with general anaesthesia. In Russia the problem is augmented with lack of physostigmine — the first choice for CAS in Germany. We present our analysis of implementing galantamine instead of physostigmine for CAS prevention and management while administering this drug for decurarization. 130 patients undergoing general anaesthesia were divided into three groups depending on decurarization — group I (n = 54) without decurarization, in group II (n = 29) we used galantamine, in group III (n = 47) — neostigmine. In all the groups we assessed CAS incidence and its galantamine treatment effectiveness. Diagnostic criteria for CAS comatose form was unconsciousness 5 min later reaching inhalational agent zero end-expiratory concentration. Using the criteria we found CAS incidence in group I was 26,9%, in group II there were no cases of the syndrome, in group III the incidence was 14,9%. Thus, galantamine 0,3–0,4 mg · kg–1 (max 0,78 mg · kg–1) IV not only prevents CAS but is also effective in its treatment.
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##article.viewOnOriginalSite##About the authors
M. S. Danilov
North-Western State Medical University names after I.I. Mechnikov
Author for correspondence.
Email: markdani@yandex.ru
Russian Federation, Saint Petersburg
K. M. Lebedinskii
North-Western State Medical University names after I.I. Mechnikov
Email: markdani@yandex.ru
Russian Federation, Saint Petersburg
I. S. Kurapeev
North-Western State Medical University names after I.I. Mechnikov
Email: markdani@yandex.ru
Russian Federation, Saint Petersburg
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