Summary
One hundred and eleven patients undergoing ketamine anaesthesia for therapeutic abortion were studied in a double-blind trial of the reversal of ketamine by physostigmine administered postoperatively. The results demonstrate that physostigmine does not shorten recovery time or reduce the occurrence of ketamine emergence phenomena such as hallucinations, restlessness and dreams. In fact, the recovery course was prolonged in patients given physostigmine immediately upon termination of anaesthesia as compared with controls. By contrast, when physostigmine was given 30 minutes after the last dose of ketamine, the recovery was not prolonged as compared with that of the placebo-treated controls. These findings suggest some synergism between the effects of ketamine and physostigmine and should discourage the use of physostigmine as a ketamine antidote.
Résumé
Cette étude à double insu porte sur ce renversement de la kétamine par la physostigmine administrée pendant la période post-opératoire à cent onze patientes anesthésiées pour un avortement thérapeutique. Les résultats montrent que la physostigmine ne raccourcit pas le temps de récupération ni ne diminue ľincidence des phénomènes ďémergence associés à la kétamine (hallucinations, agitation, rêves). En réalité, la récupération des patientes qui avaient reçu de la physostigmine immédiatement après ľanesthésie fut prolongée comparativement aux contrôles. Par contre, si la physostigmine était administrée 30 minutes après la dernière dose de kétamine, la récupération ne s’est pas prolongée en comparaison avec les patientes qui avaient reçu un placebo. Ces résultats laissant supposer ľexistence de synergisme entre les effects de la kétamine et de la physostigmine et devraient décourager ľusage de la physostigmine comme antidote de la kétamine.
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Drummond, J.C., Brebner, J., Galloon, S. et al. A randomized evaluation of the reversal of ketamine by physostigmine. Canad. Anaesth. Soc. J. 26, 288–295 (1979). https://doi.org/10.1007/BF03006289
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DOI: https://doi.org/10.1007/BF03006289