Postoperative Central Anticholinergic Syndrome: Is it Really that Rare?

CAS is the term used to describe the blockade of cholinergic neurotransmission in the central nervous system.1 Medications that cause CAS are lipophilic in nature, which allow them to cross the blood-brain barrier and gain access to the central nervous system.2 The effects of these medications in th...

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Bibliographic Details
Published in:The American surgeon 2017-03, Vol.83 (3), p.104-105
Main Authors: Quang, Celia Y., Blair, Scott G., Watson, Robert, Brevard, Sidney B., Simmons, Jon D., Tan, Marcus C.B.
Format: Article
Language:English
Subjects:
Anesthesia
Anticholinergics
Atropine
Blood-brain barrier
Cardiac arrhythmia
Central nervous system
Coma
Consciousness
Delirium
Diagnosis
Hallucinations
Hypoxia
Intoxication
Narcotics
Nervous system
Postoperative period
Seizures
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Summary:CAS is the term used to describe the blockade of cholinergic neurotransmission in the central nervous system.1 Medications that cause CAS are lipophilic in nature, which allow them to cross the blood-brain barrier and gain access to the central nervous system.2 The effects of these medications in the CNS are identical to the neurologic manifestations of atropine intoxication. Patients may exhibit signs of agitation, such as seizures, restlessness, and hallucinations, or decreased levels of consciousness, such as stupor, coma, and respiratory depression.1 The diagnosis of CAS is hampered by the wide differential diagnosis of delirium, especially after general anesthesia. [...]the true incidence of CAS is unknown, but has been reported to range from one percent to forty percent3.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481708300315