Neostigmine and edrophonium as antagonists of atracurium and pancuronium.
Edrophonium 0.5 mg/kg or neostigmine 0.04 mg/kg were administered to two groups of 30 patients each for antagonism of atracurium- or pancuronium-induced neuromuscular block at 25% single twitch recovery. Neuromuscular block was studied using both single twitch and train-of-four (TOF) nerve stimulation. The times to 100% single twitch recovery were significantly more rapid for patients receiving edrophonium (P less than 0.01) in both groups (atracurium and pancuronium); the TOF ratios were similar for atracurium, but for pancuronium they were greater after neostigmine than after edrophonium, and only at 25 min were these ratios similar. It is concluded that edrophonium in a dose of 0.5 mg/kg antagonizes neuromuscular blockade induced by atracurium, as does neostigmine in a dose of 0.04 mg/kg, but the former does not consistently antagonize neuromuscular blockade induced by pancuronium even at 25% of single twitch recovery.
Sanfilippo
M
M
Department of Anaesthesiology and Intensive Care, State University La Sapienza, Rome, Italy.
Vilardi
V
V
Fierro
G
G
Rosa
G
G
Pelaia
P
P
Gasparetto
A
A
D000328:Adult; D000768:Anesthesia, General; D001279:Atracurium / Q000037:antagonists & inhibitors*; D004491:Edrophonium / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D008875:Middle Aged; D009388:Neostigmine / Q000008:administration & dosage / Q000494:pharmacology*; D009469:Neuromuscular Junction / Q000187:drug effects; D010197:Pancuronium / Q000037:antagonists & inhibitors*; D009435:Synaptic Transmission / Q000187:drug effects; D013997:Time Factors
D001279:Atracurium; D009388:Neostigmine; D004491:Edrophonium; D010197:Pancuronium