Post-operative central anticholinergic syndrome

Cook, Bertrand A.; Spence, A.

doi:10.1046/j.1365-2346.1997.00074.x

Cited by 14 publications

(9 citation statements)

References 9 publications

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“…The present study showed the efficacy of premedication with desmopressin in reducing blood loss in FESS. This finding may be attributed to the hemostatic effects of desmopressin, which include an increase in plasma coagulation factor VII, von Willebrand factor, and tissue plasminogen activator, and improvement of adhesiveness of platelets [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Desmopressin has also been used to reduce the prolonged bleeding time that often accompanies uremia, hepatic cirrhosis, and other causes of platelet dysfunction. Hemostatic effects of desmopressin include increasing plasma concentrations of coagulation factor VII, von Willebrand factor, and tissue plasminogen activator; improving platelet adhesiveness; and reducing bleeding time [ 5 ]. Several studies have been performed on patients undergoing various types of surgeries.…”

Section: Introductionmentioning

confidence: 99%

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Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial

et al. 2015

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BackgroundBleeding during functional endoscopic sinus surgery is a challenge for the quality of the surgical field for surgeons. This study aimed to evaluate the effect of desmopressin premedication on blood loss and the quality of the surgical field in endoscopic sinus surgery.MethodsA total of 90 American Society of Anesthesiologists physical status I–II patients underwent endoscopic sinus surgery for chronic sinusitis. They were randomly allocated to receive either desmopressin 0.3 μg/kg or saline before the operation. Management of anesthesia was achieved with propofol and remifentanil infusions, with moderate, controlled hypotension. Blood loss and quality of the surgical field were assessed after surgery. Effects of desmopressin on anesthetic requirements and hemodynamic variables were analyzed.ResultsBlood loss was significantly less in the desmopressin group (mean ± SD, 42 ± 8.7 ml) than in the control group (70 ± 9.2 ml, P < 0.001). Surgeons were more satisfied with the surgical field in the desmopressin group than in the control group (median score, 4 [3–5] vs. 7 [6–9], P < 0.001). Requirements for remifentanil and esmolol were lower in the desmopressin group than in the control group.ConclusionsPremedication with desmopressin 0.3 μg/kg can effectively reduce bleeding during endoscopic sinus surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial

et al. 2015

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“…However, likely to continue [9]. injection with ECG monitoring, and octhe reported incidence of post-operative CAS seem casionally further doses may be required.…”

Section: In 1966 To Denote An Icu Where He Remained Sedated and Intubmentioning

confidence: 99%

Undiagnosed central anticholinergic syndrome may lead to dangerous complications

Katsanoulas

Παπαϊωάννου

Fraidakis

et al. 1999

European Journal of Anaesthesiology

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“…However, it has been suspected in a child as young as 6 weeks old . The prevalence of CAS has been previously reported to be 9.4% after general anesthesia and 3.3% after regional anesthesia with sedation . However, in a more recent prospective study, Link et al found an incidence of only 1.9% in patients undergoing elective surgery under general anesthesia .…”

Section: Introductionmentioning

confidence: 97%

“…Central anticholinergic syndrome (CAS) typically occurs in adults after large (or repeated small) doses of atropine . However, it has been suspected in a child as young as 6 weeks old .…”

Section: Introductionmentioning

confidence: 99%

Central anticholinergic syndrome vs. idiosyncratic reaction triggered by a small IV dose of atropine

Cao

Cui

White

et al. 2015

Acta Anaesthesiol Scand

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A 58-year-old male was scheduled to undergo radical gastrectomy for cancer under general anesthesia. The patient developed agitation and irregular breathing after receiving a single dose of atropine (0.5 mg) to treat bradycardia immediately prior to induction of anesthesia. Within 5 min after the atropine injection, the patient became unresponsive with facial flushing and diaphoresis. When a drop in oxygen saturation was observed, a laryngeal mask airway was inserted after administering a small bolus dose of propofol (80 mg) and the patient was ventilated with 100% oxygen. Physostigmine was not administered because of the relatively low dose of atropine and the fact that his symptoms were not totally consistent with central anticholinergic syndrome (CAS). The differential diagnosis at the time also included an acute cardiovascular event and an idiosyncratic reaction to atropine. The patient fully recovered within 80 min from this highly unusual reaction to a single 0.5 mg IV dose of atropine.

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Post-operative central anticholinergic syndrome

Cited by 14 publications

References 9 publications

Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial

Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial

Undiagnosed central anticholinergic syndrome may lead to dangerous complications

Central anticholinergic syndrome vs. idiosyncratic reaction triggered by a small IV dose of atropine

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