The Effects of Physostigmine on Arousal after Laryngomicroscopic surgery / 대한마취과학회지

ABSTRACT

Physostigmine has been used to counteract somnolence or coma induced by different types of phamacological agent, such as anticholinergics, opioids, ketamine and tricyclic antidepressants. In this study, we have assesed the effects of physostigmine on arousal after laryngomicroscopic surgery under enflurane-N2O general anesthesia and the effects of muscle relaxants. Forty patients were divided randomly into four groups such as I (succinylcholine only), II (vecuronium only), III(succinylcholine and physostigmine) and IV(vecuronium and physostigmine). Physostigmine 1mg was administered intravenously at the end of operation. We evaluated the recovery time of spontaneous respiration, gag reflex, pain response, extubation, eye opening on command and orientation after the end of operation. We also observed the end tidal CO2 and expired enflurane concentration with SARA(R) spectrometry at the end of operation and at the time of each recovery parameters returned . Our results revealed that physostigmine groups(group III and IV) were recovered more rapidly in the recovery time of eye opening to verbal command and orientation than non-physostigmine groups(group I and II ). But there was no difference in recovery time of spontaneous respiration, gag reflex, pain response and extubation. Therefore, we concluded that physostigmine 1 mg, i.v. has the effects of early arousal after short and deep general anesthesia and it did not show any specific complications such as bradycardia, bronchospasm, nausea and vomiting.