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Anesth Analg 2002;94:569-572
© 2002 International Anesthesia Research Society

AMBULATORY ANESTHESIA

Physostigmine Does Not Antagonize Sevoflurane Anesthesia Assessed by Bispectral Index or Enhances Recovery

Adia Paraskeva, MD*, Konstantinos Papilas, MD DEAA*, Argyro Fassoulaki, MD PhD, DEAA{dagger}, Aikaterini Melemeni, MD*, and Georgios Papadopoulos, MD PhD{ddagger}

*Department of Anesthesiology, St Savas Hospital, Athens; {dagger}Department of Anesthesiology, Aretaieion Hospital, Athens; and {ddagger}Medical School, University of Ioannina

Address correspondence and reprint requests to Argyro Fassoulaki, Department of Anesthesiology, Aretaieion Hospital, 57-59 Raftopoulou St., 11744 Athens, Greece. Address e-mail to afassou1{at}otenet.gr

In this double-blinded study, we investigated the effect of physostigmine on sevoflurane anesthesia and recovery. Forty female patients scheduled for breast biopsy were randomly assigned to receive either physostigmine 2 mg IV or an equal volume of normal saline after skin closure. Anesthesia was induced and maintained with sevoflurane in oxygen. After skin closure, a steady state of 0.6% inspired and end-tidal sevoflurane concentration was obtained, heart rate, blood pressure, and Bispectral index (BIS) baseline values were recorded, and physostigmine or normal saline was administered. Hemodynamics and BIS values were also recorded 5, 8, and 10 min after treatments. Anesthesia was discontinued, and orientation, sedation, sitting ability, and "picking up matches" scores were recorded immediately after extubation and 15 and 30 min later. No differences were found between the two groups in BIS (69, 70, 70, and 71 in the Physostigmine group versus 70, 74, 75, and 76 in the Control group) or blood pressure. Only heart rate was increased 8 min after physostigmine (P < 0.05 versus the control). Scores assessing early recovery were similar in the two groups at all time points. We conclude that physostigmine does not change BIS or enhance recovery after sevoflurane anesthesia.

IMPLICATIONS: This double-blinded, randomized study investigated the impact of physostigmine of BIS values during 0.6% sevoflurane anesthesia as well as in the postoperative recovery, when sevoflurane is administered as a sole anesthetic. Physostigmine has no effect on BIS values or on the tests assessing recovery.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.