We report a case of an 85-year-old woman with delayed awakening from general anesthesia caused by psychological unresponsiveness. She underwent an open reduction of the right femoral bone fracture. Induction of general anesthesia was done with fentanyl, propofol, sevoflurane, and rocuronium. Anesthesia was maintained with sevoflurane and remifentanil without any incidents. After the operation she opened her eyes and tried to extubate the endtracheal tube and then she was extubated. She developed coma and did not respond to painful stimuli after extubation, but spontaneous breathing was maintained with stable hemodynamics. Although naloxone was given, she was still comatose. Her clinical neurological findings and the brain CT scan showed no organic abnormalities. The bispectral index showed the value of 85 to 95; 2.5 hrs after operation she moved her extremities in response to pain and 3.5 hrs after operation she gradually woke up and obeyed commands. After fully awakening she showed no clinical manifestations of psychological abnormality during her postoperative period and no sequela.
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