[Cholinesterase inhibitors. Importance in anaesthesia, intensive care medicine, emergency medicine and pain therapy]

Many drugs currently used in anaesthesia practice modify cholinergic transmission, therefore, acetylcholinesterase inhibitors are a part of anaesthetic pharmacology. Besides its well established use in the antagonism of neuromuscular blockades and the therapy of central anticholinergic syndrome (CAS), results of controlled studies and case reports suggest other favourable indications such as the prevention and therapy of postanaesthetic shivering and the treatment of various types of intoxication and delirium. Cholinesterase inhibitors may also have analgesic properties. This review summarises the pharmacological and physiological background and describes favourable indications of this class of drugs.