[CENTRAL ANTICHOLINERGIC... SYNDROME?]

Area of Science:

• Anesthesiology
• Neuropharmacology
• Toxicology

Context:

• The term 'central anticholinergic syndrome' (ZAS) is prevalent in German and Spanish anesthesia literature.
• In contrast, Russian, English, and French literature primarily associates ZAS with toxicological contexts.
• This discrepancy highlights differing international perspectives on a significant anesthesia complication.

Purpose:

• To analyze the varying international recognition and conceptualization of central anticholinergic syndrome (ZAS).
• To describe the etiology, pathogenesis, symptoms, diagnosis, and treatment of ZAS as an anesthesia complication.
• To investigate the reasons behind the divergent approaches to managing ZAS across different linguistic and professional communities.

Summary:

• Central anticholinergic syndrome (ZAS), a complication affecting up to 10% of general anesthesia cases, presents with diverse neurological symptoms (comatose, agitated, shivering).
• The German concept of ZAS offers a pathogenically generalized approach to management.
• Other regions often employ symptomatic treatments, suggesting ZAS may not be a clearly defined nosological entity but rather an adverse effect of anesthesia mechanisms.

Impact:

• Promotes a more unified understanding and diagnostic framework for central anticholinergic syndrome (ZAS) in anesthesia.
• Encourages a shift from symptomatic treatment to a pathogenically generalized approach for ZAS.
• Aims to improve patient safety and anesthetic management by addressing a common yet inconsistently recognized complication.