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Antagonism of atracurium with neostigmine
Author(s) -
Goldhill D. R.,
Carter J. A.,
Suresh D.,
Whitehead J. P.,
Flynn P. J.
Publication year - 1991
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1991.tb11696.x
Subject(s) - neostigmine , medicine , antagonism , isoflurane , anesthesia , atracurium besilate , nitrous oxide , bolus (digestion) , neuromuscular transmission , surgery , neuromuscular blockade , receptor
Summary In 36 patients in whom anaesthesia was maintained with nitrous oxide and 0.5% isoflurane an atracurium‐induced neuromuscular block was either allowed to recover spontaneously or antagonised with one of four doses of neostigmine (15 μg/kg, 35 μg/kg, 55 μg/kg or 75 μg/kg). The recovery times to a train‐of‐four ratio of 0.5, 0.75 and 0.9 were recorded. In patients given neostigmine, antagonism was at an average TI of between 8.8% and 14.9%. There was no difference in the recovery times between the patients given neostigmine 35 μg/kg, 55 μg/kg or 75 μg/kg. Recovery after neostigmine 15 μg/kg was significantly slower than after the higher doses. One patient given neostigmine 75 μg/kg showed an unusual bimodal pattern of recovery. There appears to be no benefit in giving a larger dose than 35 μg/kg of neostogmine as a single bolus.