Abstract
We present two delayed awaken cases that underwent general anesthesia and showed altered mentality with unresponsiveness in the postanesthesia care unit (PACU) after successful extubation in the operating room. Both patients had been taking benzodiazepines chronically before surgery. In case 1, extubation was carried out without any problems and arrived at the PACU. After 15 minutes, she suddenly developed hyperventilation, shivering, and a state of consciousness that does not respond to verbal command. Eyes were kept closed and she showed decreased pain withdrawal response in all extremities. After 90 minutes at PACU, she was able to obey simple verbal instructions. All symptoms showed gradual improvement within 5-6 hours. In case 2, 20 minutes after transferal to PACU, the patient showed drowsy mentality with no response to verbal or pain stimuli. Altered mental state lasted 3 days and motor weakness of extremities lasted 5 days. Brain MRI and other examinations showed no abnormalities. They were discharged without any neurological complications.
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