[Pharmacologic modification of vigilance in the postnarcotic phase-- naloxone or physostigmine?]

Anasth Intensivther Notfallmed. 1988 Aug;23(4):209-13.
[Article in German]

Abstract

The usefulness of physostigmine in reversing post-narcotic depression after general anaesthesia is well proven; so is that of naloxone, a specific opioid analgetics antagonist, in reversing neuroleptic anaesthesia effects. Morphine-like analgetics are widely used as premedication agents, too; on the other hand, physostigmine reverses opioids as well as other psychotropic and narcotic agents. For that reason, positive post-narcotic physostigmine effects could be due to its anti-opioid potency as well. In a double-blind, randomised study, physostigmine and naloxone were evaluated using a clinically based vigilance protocol, and compared with saline solution. Naloxone did not have remarkable advantages as compared with placebo, while physostigmine led to a significantly higher level of vigilance; moreover, that level was reached sooner. The positive effects of physostigmine in restoring a sufficient level of vigilance after general anaesthesia are, in respect of our findings, unrelated to its antagonism to morphine-like analgetics.

Publication types

  • Clinical Trial
  • Comparative Study
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anesthesia, General*
  • Arousal / drug effects*
  • Clinical Trials as Topic
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Naloxone / administration & dosage*
  • Narcotics*
  • Physostigmine / administration & dosage*
  • Random Allocation

Substances

  • Narcotics
  • Naloxone
  • Physostigmine