Central anticholinergic syndrome in a child undergoing circumcision

• Published in: Acta anaesthesiologica Scandinavica Vol. 46; no. 2; pp. 224 - 226
• Main Authors: Schultz, U., Idelberger, R., Rossaint, R., Buhre, W.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science, Ltd 01-02-2002; Blackwell
• Subjects: Anesthesia; Anesthesia - adverse effects; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; central anticholinergic syndrome; Central Nervous System Diseases - chemically induced; Child; Circumcision, Male - adverse effects; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Humans; infants; Male; Medical sciences; Parasympatholytics - adverse effects; physostigmine; Physostigmine - therapeutic use; Syndrome; Human; Postoperative; Enzyme; Enzyme inhibitor; General anesthesia; Esterases; Physostigmine; Sedation; Cholinesterase; Carboxylic ester hydrolases; Case study; Alkaloid; Chemotherapy; Treatment; Surgery; Hydrolases; Complication; Anticholinesterase agent; Child; Circumcision; Prolonged
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1034/j.1399-6576.2002.460220.x

We describe one of the few pediatric cases of central anticholinergic syndrome (CAS) in an 8‐year‐old boy undergoing elective surgery. Deep sedation, inadequate response to stimuli and reduced muscular tone of the upper airway resulting in airway obstruction were the clinical manifestations of CAS. The symptoms resolved immediately after administration of physostigmine. This case illustrates the importance of considering central anticholinergic syndrome as a differential diagnosis in children if prolonged sedation after general anesthesia occurs.