title: Neostigmine after spontaneous recovery from neuromuscular blockade. Effect on depth of blockade monitored with train-of-four and tetanic stimuli.
abstract: The effect of neostigmine on neuromuscular function was examined after spontaneous recovery from an atracurium-induced neuromuscular blockade, which reached a train-of-four ratio of either 0.5 or 0.9. Two doses of neostigmine 2.5 mg were given 5 minutes apart. Neuromuscular recovery was assessed with train-of-four and tetanic stimuli. The first dose of neostigmine antagonised the neuromuscular blockade. The second dose diminished tetanic height and increased tetanic fade. The train-of-four measured mechanically was adversely affected to a small degree, but when measured with the electromyograph no significant change occurred. Neostigmine may adversely affect neuromuscular function after spontaneous recovery from a non-depolarising block. This is unlikely with a single modest dose and any effects are probably short-lived.
authors.affiliation: Anaesthetic Department, London Hospital, Whitechapel.
authors.forename: D R
authors.initials: DR
authors.lastname: Goldhill
authors.forename: A P
authors.initials: AP
authors.lastname: Wainwright
authors.forename: C S
authors.initials: CS
authors.lastname: Stuart
authors.forename: P J
authors.initials: PJ
authors.lastname: Flynn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001279:Atracurium; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000187:drug effects* / Q000502:physiology; D009388:Neostigmine / Q000008:administration & dosage / Q000009:adverse effects*; D009407:Nerve Block; D009469:Neuromuscular Junction / Q000187:drug effects
chemical_list: D001279:Atracurium; D009388:Neostigmine