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  • Delayed Recovery

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    Krishnendra Mulgund
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    The document discusses several potential causes of delayed recovery from anesthesia, including pharmacological interactions between anesthetic agents like benzodiazepines, opioids, neuromuscular blocking drugs, and intravenous induction agents; physiological issues like air embolism or intracranial pathology; and various metabolic derangements such as hypoglycemia, hyperglycemia, hyponatremia, hypernatraemia, uraemia, or hypothermia. Central anticholinergic syndrome is also listed as a potential cause of delayed recovery.

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    The document discusses several potential causes of delayed recovery from anesthesia, including pharmacological interactions between anesthetic agents like benzodiazepines, opioids, neuromuscular blocking drugs, and intravenous induction agents; physiological issues like air embolism or intracranial pathology; and various metabolic derangements such as hypoglycemia, hyperglycemia, hyponatremia, hypernatraemia, uraemia, or hypothermia. Central anticholinergic syndrome is also listed as a potential cause of delayed recovery.

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    © All Rights Reserved
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    12 views2 pages

    Delayed Recovery

    Uploaded by

    Krishnendra Mulgund
    The document discusses several potential causes of delayed recovery from anesthesia, including pharmacological interactions between anesthetic agents like benzodiazepines, opioids, neuromuscular blocking drugs, and intravenous induction agents; physiological issues like air embolism or intracranial pathology; and various metabolic derangements such as hypoglycemia, hyperglycemia, hyponatremia, hypernatraemia, uraemia, or hypothermia. Central anticholinergic syndrome is also listed as a potential cause of delayed recovery.

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    of 2

    Midazolam is metabolised by the

    Benzodiazepines
    same p450 iso-enzyme

    Reduce clearance of volatiles,


    Opioids
    cause hypercapnoea etc

    Pharmacological
    NMBDs
    Air embolus

    Typically 80% reduction in effect site


    IV induction agents
    LA Neurological concentration is required for awakening

    Intracranial pathology CEACCP Volatile agents Awakening is usually at about 0.3 MAC

    Delayed
    recovery

    Central anticholinergic syndrome Hypoglycaemia BG <2.2 mmol/L

    Dissociative coma Uncommon causes Hyperglycaemia BG >14 mmol/L

    Myxoedema Hyponatraemia <120 causes confusion


    Metabolic
    Hypernatraemia Less common

    Uraemia

    Hypothermia <35 degrees


    /Delayed recovery/CEACCP
    http://ceaccp.oxfordjournals.org/content/6/3/114.full.pdf

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