Physostigmine reversal of benzquinamide-induced delirium.
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Biomedical subjects
Publications and source records attributed to D W Wingard.
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Malignant hyperthermia in susceptible swine was completely blocked by epidural anesthesia with lidocaine. Incomplete epidural anesthesia modified the disease but did not prevent it. These studies indicate the importance of the nervous system in the triggering of malignant hyperthermia. (Key words: Hyperthermia, malignant; Anesthetic technique, peridural.).
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Diazepam is a valuable and widely-used adjunct to many inpatient and outpatient diagnostic and therapeutic procedures. However, the occasional and often unexpected delirium or coma induced by even modest doses of diazepam can be life threatening. Four cases are reported which demonstrate the prompt and effective reversal of diazepam-induced delirium and coma by the administration of physostigmine.
Lidocaine, considered by some to be potentially dangerous in malignant hyperthermia (MH), was administered intravenously to a dose of 15 mg/kg to five conscious MH-susceptible pigs. Subsequently the same pigs were given 24 mg/kg intravenously over a period of 2 hours after being anesthetized with thiopental. All animals developed systemic toxicity to lidocaine but without evidence of MH. Prior administration of lidocaine did not prevent development of subsequent MH due to succinylcholine and halothane. Lidocaine is safe in porcine MH.
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