Dissoziativer Stupor als Komplikation nach Allgemeinanästhesie

Since the advent of short acting anaesthetic drugs the failure of a patient to awaken after general anaesthesia is a rare event. Besides the hangover of anaesthetic substances, persistent unconsciousness can also be caused by metabolic disorders, neurological or psychiatric diseases. We report a 30-yr-old woman, who underwent minor breast surgery and failed to recover promptly after general anaesthesia. Physostigmine was administered at the thought of a central anticholinergic syndrome (CAS) but the patient relapsed to unresponsiveness after a short period of awakening. No abnormalities were detected on neurological examination or laboratory investigations and the vital signs remained stable. Finally, a dissociative stupor, which is a type of conversion neurosis, was diagnosed. The patient recovered more than 8 hours later without specific therapy with complete amnesia but without further complications.