Effect on cognition of galanthamine administered for neuromuscular block reversal in octogenarians undergoing cataract surgery.

Background: The purpose of the study was to determine the possible effect of the cholinesterase inhibitor, galanthamine, on cognition when administered to antagonise neuromuscular blockade after anaesthesia.

Methods: The Wechsler Memory Scale was used to assess cognition before and after cataract surgery, carried out under general anaesthesia, in forty-five octogenarian patients. At the end of the operation, in order to reverse residual neuromuscular blockade, patients were randomly assigned to receive either galanthamine, acting on central and peripheral receptors, or neostigmine--a drug without central activity.

Results: The differences between the Wechsler Memory Scale scores obtained from both groups were not statistically significant; however, patients who received galanthamine experienced more side effects (e.g. nausea, vomiting, dysphoria) and had lower scores in memory tests performed immediately after surgery. Reduction of galanthamine doses did not improve the situation.

Conclusions: In octogenarians, impaired organ function as well as changes in body composition, are factors which affect the pharmacodynamics and pharmacokinetics of drugs.