Abstract
Propofol is frequently used for intravenous sedation or anesthesia in ambulatory and office-based anesthesia. Although awakening is usually rapid, there are instances of delayed recovery from propofol anesthesia. It has been reported that aminophylline antagonizes the sedative effects of several anesthetic and analgesic drugs. The case reports presented here demonstrate that intravenous aminophylline effectively reversed prolonged propofol-induced sedation/anesthesia in the postoperative period. There were no side effects or delayed re-sedation after the administration of aminophylline. Our study suggests that aminophylline could be a clinically useful propofol antagonist.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Arvidsson SB, Ekstrom-Jodel B, Martinell SAG, Niemand D (1982) Aminophylline antagonizes diazepam sedation. Lancet II:1467
Marrosu F, Marchi A, De Martino MR, Saba G, Gessa GL (1985) Aminophylline antagonizes diazepam-induced anesthesia and EEG changes in humans. Psychopharmacology 85:69–70
Gürel A, Elevli M, Hamula A (1987) Aminophylline reversal of flunitrazepam sedation. Anesth Analg 66:333–336
Hoegholm A, Steptoe P, Fogh B, Caldara A, Pedersen C (1989) Benzodiazepine antagonism by aminophylline. Acta Anaesth Scand 33:164–166
Krintel JJ, Wegmann F (1987) Aminophylline reduces the depth and duration of sedation with barbiturates. Acta Anaesthesiol Scand 31:352–354
Chen YC, Chan KH, Tsou MY, Wang H, Ho YY, Lee TY (1993) The reversal effect of low dose aminophylline on thiopental-induced sedation. Chin Med J 52:145–148
Turan A, Memis D, Karamanlyodthlu B, Pamukcu Z, Sut N (2004) Effect of aminophylline on bispectral index. Acta Anaesthesiol Scand 48:408–411
Stirt JA (1983) Aminophylline may act as a morphine antagonist. Anaesthesia 38:275–278
Meuret P, Backman SB, Bonhomme V, Plourde G, Fiset P (2000) Physostigmine reverses propofol-induced unconsciousness and attenuation of the auditory steady state response and bispectral index in human volunteers. Anesthesiology 93:708–717
Avant GR, Speeg KV Jr, Freemon FR, Schenker S, Berman ML (1979) Physostigmine reversal of diazepam-induced hypnosis. A study in human volunteers. Ann Intern Med 91:53–55
Hartvig P, Lindstrom B, Pettersson E, Wiklund L (1989) Reversal of postoperative somnolence using a two-rate infusion of physostigmine. Acta Anaesthesiol Scand 33:681–685
Niemand D, Martinell S, Arvidsson S, Ekström-Jodal B, Svedmyr N (1986) Adenosine in the inhibition of diazepam sedation by aminophylline. Acta Anaesthesiol Scand 30:493–495
Williams M, Jarvis MF (1988) Adenosine antagonists as potential therapeutic agents. Pharmacol Biochem Behav 29:433–441
Radulovacki M (1991) Adenosine and sleep. In: Phillis JW (ed) Adenosine and adenine nucleotides as regulatiors of cellular function. CRC, Boca Raton, pp 381–390
Satoh S, Matsumura H, Suzuki F, Hayaishi O (1996) Promotion of sleep mediated by the A2a-adenosine receptor and possible involvement of his receptor in the sleep induced by prostaglandin D2 in rats. Proc Natl Acad Sci USA 93:5980–5984
Porkka-Heiskanen T, Strecker RE, Thakkar M, Bjorkum AA, Greene RW, McCarley RW (1997) A mediator of the sleep-inducing effects of prolonged wakefulness. Science 276:1265–1268
Tanase D, Baghdoyan HA, Lydic R (2003) Dialysis delivery of an adenosine A1 receptor agonist to the pontine reticular formation decreases acetylcholine release and increases anesthesia recovery time. Anesthesiology 98:912–920
Tung A, Herrera S, Szafran MJ, Kasza K, Mendelson WB (2005) Effect of sleep deprivation on righting reflex in the rat is partially reversed by administration of adenosine A1 and A2 receptor antagonists. Anesthesiology 102:1158–1164
Piafsky KM, Ogilvie RI (1975) Dosage of theophylline in bronchial asthma. N Engl J Med 292:1218–1222
Horai Y, Ishizaki T, Sasaki T, Chiba K, Suganuma T, Echizen H, Ohnishi A (1983) Biovavailability and pharmacokinetics of theophylline in plain uncoated and sustained-release dosage forms in relation to smoking habit. I. Single dose study. Eur J Clin Pharmacol 24:79–87
Author information
Authors and Affiliations
About this article
Cite this article
Sakurai, S., Fukunaga, A., Fukuda, K. et al. Aminophylline reversal of prolonged postoperative sedation induced by propofol. J Anesth 22, 86–88 (2008). https://doi.org/10.1007/s00540-007-0587-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00540-007-0587-x