Antagonism of atracurium with neostigmine. Effect of dose on speed of recovery.
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 micrograms/kg, 35 micrograms/kg, 55 micrograms/kg or 75 micrograms/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 T1 of between 8.8% and 14.9%. There was no difference in the recovery times between the patients given neostigmine 35 micrograms/kg, 55 micrograms/kg or 75 micrograms/kg. Recovery after neostigmine 15 micrograms/kg was significantly slower than after the higher doses. One patient given neostigmine 75 micrograms/kg showed an unusual bimodal pattern of recovery. There appears to be no benefit in giving a larger dose than 35 micrograms/kg of neostogmine as a single bolus.
Goldhill
D R
DR
Anaesthetics Unit, London Hospital.
Carter
J A
JA
Suresh
D
D
Whitehead
J P
JP
Flynn
P J
PJ
D000328:Adult; D000762:Anesthesia Recovery Period; D001279:Atracurium / Q000037:antagonists & inhibitors*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D009388:Neostigmine / Q000008:administration & dosage*; D009407:Nerve Block / Q000379:methods*
D001279:Atracurium; D009388:Neostigmine