Emergence
Delirium/Physostigmine
An 87yo woman s/p hysterectomy under general anesthesia is confused, combative, and disoriented. She received no premedication, 4 mg of morphine during the case, and was anesthetised with sevoflurane and nitrous oxide.
References: (note, all residents should have access to Anesthesiology articles online if they receive the journal. Many other journals are available with a USF account through MD Consult...just access it from the departmental home page)
An 87yo woman s/p hysterectomy under general anesthesia is confused, combative, and disoriented. She received no premedication, 4 mg of morphine during the case, and was anesthetised with sevoflurane and nitrous oxide.
- What is your differential diagnosis?
- How do you differentiate
between the many causes of delirium in this patient?
- What is physostigmine, how
does it work, and what is the dose?
References: (note, all residents should have access to Anesthesiology articles online if they receive the journal. Many other journals are available with a USF account through MD Consult...just access it from the departmental home page)