Aminophylline reversal of prolonged postoperative sedation induced by propofol

Abstract

Propofol is frequently used for intravenous sedation or anesthesia in ambulatory and office-based anesthesia. Although awakening is usually rapid, there are instances of delayed recovery from propofol anesthesia. It has been reported that aminophylline antagonizes the sedative effects of several anesthetic and analgesic drugs. The case reports presented here demonstrate that intravenous aminophylline effectively reversed prolonged propofol-induced sedation/anesthesia in the postoperative period. There were no side effects or delayed re-sedation after the administration of aminophylline. Our study suggests that aminophylline could be a clinically useful propofol antagonist.

Impact of aminophylline on the pharmacodynamics of propofol in beagle dogs

“…This inference may be supported by many previous clinical study outcomes [12,35,39,42]. In an earlier case report, long-term infusion of aminophylline (13 days) was associated with increased requirement of propofol for sedation in intensive care unit, which was decreased 36 h after withdrawal of aminophylline [39].…”

“…In an earlier case report, long-term infusion of aminophylline (13 days) was associated with increased requirement of propofol for sedation in intensive care unit, which was decreased 36 h after withdrawal of aminophylline [39]. In the meantime, an intravenous bolus [12,35] and 1 h short-term infusion [42] of aminophylline were also associated with more prompt awakening from, and significant increase of bispectral index during propofol anesthesia. Together with our results, these findings suggest that the antagonistic interaction of aminophylline with propofol-induced hypnosis can be triggered even by a bolus of aminophylline.…”

“…Although the decreasing tendencies of AAC of ApEn and ApEn baseline -ApEn min with increasing infusion rate of aminophylline over 4 periods was statistically insignificant, several clinical studies have demonstrated that the propofol effect on the central nervous system is antagonized by aminophylline [12,35,39,42]. Aminophylline-induced alterations of pharmacokinetics and/or pharmacodynamics of propofol might underlie this phenomenon.…”

A Comparison of the Effects of Low and High Doses of Aminophylline on Recovery Time and the Bispectral Index Score Following Iso flurane Anesthesia

“…Aminophylline is a methylxanthine found in coffee and tea, and it can partially antagonize the behavioral and hypnotic effects of benzodiazepines (12). This drug works clinically to centrally antagonize adenosine, which is a potent, endogenous central nervous system (CNS) depressant (13). When administered at the routine clinical therapeutic dose, aminophylline increases ventilation and the electromyography activity of both inspiratory and expiratory muscles (14).…”

Antidepressant Effect of Aminophylline After Ethanol Exposure

“…Another clinical use of aminophylline, due to its stimulatory effect, occurs in anesthesia to accelerate the consciousness recovery process after general anesthesia [29]. …”