Prophylactic Physostigmine for Extreme and Refractory Adult Emergence Delirium, Aimed at Increasing Patient Safety and Reducing Health Care Workplace Violence: A Case Report

A A Pract. 2020 Apr;14(6):e01205. doi: 10.1213/XAA.0000000000001205.


Emergence delirium is a well-known phenomenon that may be encountered after general anesthesia. A common approach to this issue is to risk stratify patients preoperatively and treat them postoperatively if emergence delirium occurs. We present the case of a patient with Barrett esophagus and a history of severe and refractory emergence delirium, who was successfully treated prophylactically with physostigmine, resulting in decreased risk of harm to the patient, trauma to the perioperative staff, and a safer and more positive recovery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Delivery of Health Care
  • Emergence Delirium* / prevention & control
  • Humans
  • Patient Safety
  • Physostigmine* / therapeutic use
  • Workplace Violence*


  • Physostigmine