We recommend the use of one dose of physostigmine salicylate, a few minutes before the termination of a general anesthetic, to prevent confusion, struggling, disorientation, or delirium during the recovery from anesthesia. We believe that it is well to prevent such behavior, particularly in patients who have just undergone reconstructive surgery where the unmanageable behavior could jeopardize surgical results. Our results indicate that such behavior is largely preventable.