Causes of Prolonged Emergence - Anesthesiology



Prolonged Drug Action:

• Overdose 

• Hypothermia (< 33 C) 

• Incr sensitivity 

• Decr protein binding 

• Redistribution 

• Drug interaction 



Metabolic Causes:

• Hypoxia / hypercapnia 

• Organ dysfunction 

    — hepatic 

    — renal 

    — endocrine 

• Hypoglycemia / hyperglycemia 

• HONK / diabetic ketoacidosis 

• Electrolyte imbalance: 

    — hyponatræmia 

    — hypocalcæmia 

    — hypomagnesæmia 

• Hypothermia (< 33 C) 

• Sepsis 

• Alcohol 



Neurologic Injury:

 • Intracranial: 

    — hæmorrhage 

    — contusion 

 • Cerebral embolus / ischæmia 

 • Seizure: 

    — subclinical 

    — post-ictal state 

 • Incr intracranial pressure 

 • Pneumocephalus 



Mark Harris, MD MPH @ https://twitter.com/MarkHarrisMD



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