Anesthesia: Essays and Researches

LETTER TO EDITOR
Year
: 2016  |  Volume : 10  |  Issue : 3  |  Page : 689--690

Caffeine for delayed recovery


Madhuri S Kurdi 
 Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India

Correspondence Address:
Madhuri S Kurdi
Karnataka Institute of Medical Sciences, Hubli, Karnataka
India




How to cite this article:
Kurdi MS. Caffeine for delayed recovery.Anesth Essays Res 2016;10:689-690


How to cite this URL:
Kurdi MS. Caffeine for delayed recovery. Anesth Essays Res [serial online] 2016 [cited 2020 Sep 26 ];10:689-690
Available from: http://www.aeronline.org/text.asp?2016/10/3/689/186867


Full Text



Sir,

I read with interest the postgraduate educational review on “delayed recovery from anesthesia”[1] in the May 2016 issue of your journal. Delayed recovery is a problem that every anesthesiologist will encounter sometime in his practice. At such times, a good knowledge of the causes, evaluation, and management of “delayed recovery” can be a great support. In their article, the authors have given a very elaborate account of delayed recovery from both general and regional anesthesia. I would like to add one more class of drugs – cyclic adenosine monophosphate (AMP) elevating drugs to the management of delayed recovery.

General anesthetics inhibit neurotransmitter release from both neurons and secretory cells. Intracellular cyclic AMP-elevating drugs such as forskolin, theophylline, and caffeine are known to facilitate neurotransmitter release. They were all found to dramatically accelerate recovery from isoflurane anesthesia when tested in isoflurane anesthetized rats; nevertheless, caffeine was the most effective.[2] Caffeine alone when tested on propofol anesthetized rats was found to dramatically accelerate the recovery from anesthesia.[2] In another study, intravenous 500 mg caffeine benzoate injected after the completion of surgery and the discontinuation of sevoflurane in adult patients with obstructive sleep apnea undergoing uvulopalatopharyngoplasty was found to decrease the occurrence of adverse postextubation adverse respiratory events and hastens recovery from sevoflurane anesthesia.[3] Evidence exists that caffeine might have a positive influence on early recovery of postoperative bowel activity and thus shorten hospital stay after colon surgery. Randomized controlled trials are being conducted by some researchers on this topic.[4] Caution should be exercised when administering caffeine to patients with cardiac insufficiency, cardiac arrhythmias, compromised liver function, pregnancy, and lactation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Misal US, Joshi SA, Shaikh MM. Delayed recovery from anesthesia: A postgraduate educational review. Anesth Essays Res 2016;10:164-72.
2Wang Q, Fong R, Mason P, Fox AP, Xie Z. Caffeine accelerates recovery from general anesthesia. J Neurophysiol 2014;111:1331-40.
3Gouda NM. Intravenous caffeine for adult patients with obstructive sleep apnea undergoing uvulopalatopharyngoplasty: Effects on postoperative respiratory complications and recovery profile. Med J Cairo Univ 2010;78:155-9.
4Kruse C, Müller SA, Warschkow R, Lüthi C, Brunner W, Marti L, et al. Does caffeine reduce postoperative bowel paralysis after elective laparoscopic colectomy? (CaCo trial): Study protocol for a randomized controlled trial. Trials 2016;17:186.