Delayed emergence after anesthesia

Alexander Tzabazis; Christopher Miller; Marc F Dobrow; Karl Zheng; John G Brock-Utne

doi:10.1016/j.jclinane.2015.03.023

Delayed emergence after anesthesia

J Clin Anesth. 2015 Jun;27(4):353-60. doi: 10.1016/j.jclinane.2015.03.023. Epub 2015 Apr 23.

Authors

Alexander Tzabazis¹, Christopher Miller², Marc F Dobrow², Karl Zheng², John G Brock-Utne²

Affiliations

¹ Department of Anesthesia, Pain and Perioperative Medicine, Stanford University, Stanford, CA, USA. Electronic address: alex.tzabazis@gmail.com.
² Department of Anesthesia, Pain and Perioperative Medicine, Stanford University, Stanford, CA, USA.

PMID: 25912729
DOI: 10.1016/j.jclinane.2015.03.023

Abstract

In most instances, delayed emergence from anesthesia is attributed to residual anesthetic or analgesic medications. However, delayed emergence can be secondary to unusual causes and present diagnostic dilemmas. Data from clinical studies is scarce and most available published material is comprised of case reports. In this review, we summarize and discuss less common and difficult to diagnose reasons for delayed emergence and present cases from our own experience or reference published case reports/case series. The goal is to draw attention to less common reasons for delayed emergence, identify patient populations that are potentially at risk and to help anesthesiologists identifying a possible cause why their patient is slow to wake up.

Keywords: Anesthesia; Complication; Delirium; Drug interaction; Emergence; Narcolepsy; Serotonin syndrome; Sleep paralysis.

Publication types

Review

MeSH terms

Anesthesia / methods*
Anesthesia Recovery Period*
Anesthesiology / methods
Delayed Emergence from Anesthesia / etiology*
Humans
Risk Factors
Time Factors