Central anticholinergic syndrome (CAS) in anesthesiology:  a narrative review

Authors

  • Dmytro Dmytriiev Vinnytsia National Pirogov Memorial Medical University
  • Dmytro Bortnik National Pirogov Memorial Medical University, Vinnytsia, Ukraine

DOI:

https://doi.org/10.31636/prmd.v2i1.3

Keywords:

central anticholinergic syndrome, galantamine, physostigmine, cholinolytics, muscarinic receptors, anticholinesterase

Abstract

Psychomotor excitation, delayed recovery of consciousness after general anesthesia – well-known conditions. But only in the literature of Germany, it was first isolated in a separate central anticholinergic syndrome (CAS). This article discusses the main aspects and symptoms that will help to differentiate this syndrome with other conditions, and the methods for relief of this state.

Downloads

Download data is not yet available.

References

Link J, Papadopoulos G, Dopjans D, Guggenmoos-Holzmann I, Eyrich K. Distinct central anticholinergic syndrome following general anaesthesia. European Journal of Anaesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 1997 Jan;14(1):15–23. Available from: https://doi.org/10.1046/j.1365-2346.1997.00004.x DOI: https://doi.org/10.1046/j.1365-2346.1997.00004.x

Katsanoulas K, Papaioannou A, Fraidakis O, Michaloudis D. Undiagnosed central anticholinergic syndrome may lead to dangerous complications. European Journal of Anaesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 1999 Nov;16(11):803–9. Available from: https://doi.org/10.1097/00003643-199911000-00011 DOI: https://doi.org/10.1097/00003643-199911000-00011

RUPREHT J, DWORACEK B. CENTRAL ANTICHOLINERGIC SYNDROME IN ANESTHETIC PRACTICE. Survey of Anesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 1978 Feb;22(1):22. Available from: https://doi.org/10.1097/00132586-197802000-00017 DOI: https://doi.org/10.1097/00132586-197802000-00017

Johnson JO. Autonomic Nervous System Physiology. Pharmacology and Physiology for Anesthesia [Internet]. Elsevier; 2013;208–17. Available from: https://doi.org/10.1016/b978-1-4377-1679-5.00012-0 DOI: https://doi.org/10.1016/B978-1-4377-1679-5.00012-0

Martin B, Howell PR. Physostigmine: going . . . going . . . gone? Two cases of central anticholinergic syndrome following anaesthesia and its treatment with physostigmine. European Journal of Anaesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 1997 Jul;14(4):467–70. Available from: https://doi.org/10.1046/j.1365-2346.1997.00128.x DOI: https://doi.org/10.1046/j.1365-2346.1997.00128.x

The Autonomic Nervous System and the Adrenal Medulla. Pocket Companion to Guyton and Hall Textbook of Medical Physiology [Internet]. Elsevier; 2012;458–67. Available from: https://doi.org/10.1016/b978-1-4160-5451-1.00060-8 DOI: https://doi.org/10.1016/B978-1-4160-5451-1.00060-8

Brown DV, Heller F, Barkin R. Anticholinergic Syndrome After Anesthesia: A Case Report and Review. American Journal of Therapeutics [Internet]. Ovid Technologies (Wolters Kluwer Health); 2004 Mar;11(2):144–53. Available from: https://doi.org/10.1097/00045391-200403000-00010 DOI: https://doi.org/10.1097/00045391-200403000-00010

Cook B, Spence AA. Post-operative central anticholinergic syndrome. European Journal of Anaesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 1997 Jan;14(1):1–2. Available from: https://doi.org/10.1046/j.1365-2346.1997.00074.x DOI: https://doi.org/10.1046/j.1365-2346.1997.00074.x

Omoigui S. The Anesthesia Drags Handbook. Ed 2. St Louis. MO: Mosby; 1995:270–272.

Central anticholinergic syndrome associated with atropine: case report F. Ozlem Orhan, Nimet Şenoğlu , Erman Bağcioğlu, Hilmi Demirkan.

Granacher RP. Physostigmine. Archives of General Psychiatry [Internet]. American Medical Association (AMA); 1975 Mar 1;32(3):375. Available from: https://doi.org/10.1001/archpsyc.1975.01760210109008 DOI: https://doi.org/10.1001/archpsyc.1975.01760210109008

HOLZGRAFE RE, VONDRELL JJ, MINTZ SM. Reversal of Postoperative Reactions to Scopolamine With Physostigmine. Anesthesia & Analgesia [Internet]. Ovid Technologies (Wolters Kluwer Health); 1973 Nov;52(6):921-925. Available from: https://doi.org/10.1213/00000539-197311000-00013 DOI: https://doi.org/10.1213/00000539-197311000-00013

Duvoisin RC. Reversal of Central Anticholinergic Syndrome in Man by Physostigmine. JAMA: The Journal of the American Medical Association [Internet]. American Medical Association (AMA); 1968 Nov 25;206(9):1963. Available from: https://doi.org/10.1001/jama.1968.03150090039008 DOI: https://doi.org/10.1001/jama.1968.03150090039008

Schneck HJ, Rupreht J. Central anticholinergic syndrome in anaesthesia and intensive care. Acta Anaesthesiol Belg 1989; 40: 219–227.

Torline RL. Central anticholinergic syndrome – the for¬gotten diagnosis? Anesthesiology Review 1993; 20:47-50.

Speich R, Haller A. Central Anticholinergic Syndrome with the Antimalarial Drug Mefloquine. New England Journal of Medicine [Internet]. Massachusetts Medical Society; 1994 Jul 7;331(1):57–8. Available from: https://doi.org/10.1056/nejm199407073310120 DOI: https://doi.org/10.1056/NEJM199407073310120

Central anticholinergic syndrome (CAS) in anesthesiology:  a narrative review

Published

2019-06-27

How to Cite

1.
Dmytriiev D, Bortnik D. Central anticholinergic syndrome (CAS) in anesthesiology:  a narrative review. prmd [Internet]. 2019 Jun. 27 [cited 2023 Jun. 1];2(1):22-5. Available from: https://perioperative.org.ua/index.php/prtmdc/article/view/24

Most read articles by the same author(s)