The Effect of Physostigmine on Cognitive Functioning in the Immediate Period After Sedation for Colonoscopy
The Effect of Physostigmine on Cognitive Functioning in the Immediate Period After Sedation for Colonoscopy
The purpose of this study is to determine whether the administration of physostigmine in
 combination with sedation for colonoscopy can minimize the cognitive decline at the time of
 hospital discharge
Physostigmine, a tertiary cholinesterase inhibitor, which prevents the breakdown of ACh by
 inhibiting the enzyme acetylcholinesterase (AChE), crosses the blood-brain barrier (BBB), and
 elevates brain ACh levels. Physostigmine has been shown to improve attention, and performance
 in working memory. It has also been shown to produce analgesia following systemic or central
 administration.

 Patients undergoing colonoscopy under sedation of propofol and fentanyl show cognitive
 decline in the immediate period following the procedure. In this study, half the patients
 will receive physostigmine in combination with the sedation, and their cognitive functioning
 at the time of hospital discharge will be assessed by standard neuropsychological tests, and
 compared to that of patients without physostigmine.
Inclusion Criteria:

 -  Over18 years old

 -  ASA I-III

 -  Fluency in Hebrew, Russian, or Arabic

 -  Absence of serious hearing or vision impairment

 Exclusion Criteria:

 -  History of head trauma, neurological diseases, alcoholism, drug abuse, consumption of
 psychotropic drugs or antidepressants

 -  Heart failure (NYHA > 3)

 -  Liver failure

 -  Respiratory problems (asthma, etc.)