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the literature illustrates several cases of hallucinations involving the accepted indication (insomnia) of triazolam. In 1979, van der Kroef 4 described triazolam as potentiating a “syndrome” that included reactions such as “depersonalisation, derealisation, depression, and hypnagogic hallucinations.” Although van der Kroef was criticized for the lack of validity of his claims, his accounts marked the beginning of controversy involving triazolam and delirium. 4 5 Delirium involves a failure of cognitive function characterized by confusion, disordered speech

helps minimize the risk of associated postoperative complications. Potential problems related to NSAIDs may include gastrointestinal and cardiovascular disorders, impaired platelet function, and renal issues, while opioids can cause nausea/vomiting, constipation, drowsiness, delirium/hallucinations, respiratory depression, and hyperalgesia. 3 Patient recovery from surgery and their prognosis are more favorable in the absence of such complications. Ropivacaine has 2 major advantages when used for a nerve block: a prolonged analgesic effect (12-24 hours) and

, combative and violent behavior may pose a physical danger to the patient, caretakers, and the anesthesia care team. The use of intramuscular (IM) sedative agents, which does not require patient cooperation, can facilitate an efficient transfer to the OR and induction of GA. Although IM ketamine is effective and commonly used for the management of special need patients, it has numerous undesirable side effects including dysphoria, hypersalivation, hyperreactive airway reflexes, hypertension, tachycardia, muscle hypertonia, hallucinations, increased incidence of

substitute for local anesthetic. Patients were technically conscious, highly analgesic, and well oxygenated, but the high concentrations of nitrous oxide produced a significant percentage of patients with nausea, vomiting, and hallucinations. The Langa nitrous oxide analgesia technique was ultimately modified to what became known as nitrous oxide–oxygen conscious sedation and is currently known as nitrous oxide–oxygen minimal sedation. With this technique, the nitrous oxide is typically carefully titrated to a concentration of 50% or less in combination with oxygen and is

, irritability, mutism, aggressiveness, derealization, hallucinations, and delusions); (2) hyperphagia with compulsive eating; (3) hypersexuality with inappropriate or odd behavior; and (4) abnormal behavior such as irritability, aggression, and odd behavior. 6 In accordance with these diagnostic criteria, this patient was diagnosed with KLS when she was 13 years old, presenting with recurrent episodes of hypersomnia and hyperphagia lasting for 6 to 10 days. This patient reported taking no medications to treat her KLS-related symptoms. Although several medications

as emergence delirium, hallucinations, nausea, or vomiting, noted. She was able to walk 150 minutes after cessation of anesthesia and was subsequently discharged at that time. Her OAA/S scores, vital signs (BP, HR, Sp o 2 , and RR), and total doses of anesthetic agents are summarized in Table 2 . The total operating time was 40 minutes, the total anesthesia time was 58 minutes, the emergence time was 74 minutes, and the recovery time was 150 minutes. Table 2 OAA/S Scale, Vital Signs, and Total Dosages

intraoperative adverse event to be hallucination (3.9%), while the most common postdischarge adverse event was excessive sleep (41.9%) with moderate sedation involving chloral hydrate or midazolam. This study also found that minor adverse events were significantly more likely with high oral doses of choral hydrate than with midazolam. 8 Because oral liquid chloral hydrate has been discontinued by its manufacturer, further investigation of patient discharge parameters of other oral sedation regimens is warranted. Research is needed to evaluate the recovery period of patients

remifentanil group was 24.7 ± 7.6 minutes, and mean recovery time was 42.9 ± 18.7 minutes for the ketamine group, a difference of 18.2 minutes ( P = .0004). Additionally, none of the participants reported any negative behavioral effects such as dysphoria or hallucinations. Satisfaction Surveys The results of the patient and surgeon satisfaction surveys were evaluated using the Fisher exact test ( Table 6 ). The 5-point Likert scale used the following points to measure patient satisfaction with the sedation: 1 indicated “very satisfied”; 2

potential for causing emergence hallucinations and lowering the seizure threshold in highly seizure-prone individuals. However, both of these undesirable side effects have been linked to ketamine administration at much higher doses than what was reported in the literature to help eliminate EAD. Prolongation of recovery time often associated with higher doses of ketamine should not be a concern with the dose in the above-mentioned study. Nevertheless, 16.5% still represents a high incidence of EAD. ALFENTANIL Kim et al 8 studied the

suggests midazolam 0.1 to 0.15 or ketamine 2 to 3 mg/kg with atropine 0.02 mg/kg. 5 Miller's Anesthesia suggests ketamine 4 to 5 mg/kg IM for reduction of anxiety and 5 to 10 mg/kg to induce general anesthesia. 6 Furthermore, this text also suggests IM coadministration of a benzodiazepine to reduce hallucinations and an anticholinergic to reduce sialorrhea but specifies neither specific agents nor dosages. Basics of Anesthesia recommends ketamine 5 mg/kg and notes that IM atropine or glycopyrrolate can be used (but does not specify an anticholinergic dose). 7