Antagonism of blockade produced by atracurium or vecuronium with low doses of neostigmine.
Neostigmine 1.25 mg or 0.625 mg was used to antagonize neuromuscular blockade produced by either atracurium 0.5 mg kg-1 or vecuronium 0.1 mg kg-1 in four groups of patients (n = 45) when the first EMG response of the train-of-four (A') had recovered to 10% of control (A). The time for A'/A and the train-of-four ratio (D'/A') to reach 70% was recorded. It was found that, after both atracurium and vecuronium, neostigmine 1.25 mg considerably accelerated recovery and, when compared with previous results, differed little from neostigmine 5.0 mg or 2.5 mg. Neostigmine 0.625 mg also significantly accelerated recovery after atracurium and was comparable to neostigmine 1.25 mg. However, with neostigmine 0.625 mg after vecuronium, recovery of D'/A' (but not A'/A) was little faster than spontaneous. Neostigmine 1.25 mg appears to be almost as effective as neostigmine 5.0 mg or 2.5 mg in antagonizing considerable block (90% depression of twitch height) produced by either atracurium or vecuronium, but neostigmine 0.625 mg is not sufficient, especially after vecuronium.
Jones
J E
JE
University Department of Anaesthesia, Royal Liverpool Hospital.
Parker
C J
CJ
Hunter
J M
JM
D000328:Adult; D001279:Atracurium / Q000037:antagonists & inhibitors*; D005260:Female; D006801:Humans; D008297:Male; D009388:Neostigmine / Q000008:administration & dosage / Q000494:pharmacology*; D013997:Time Factors; D014673:Vecuronium Bromide / Q000037:antagonists & inhibitors*
D001279:Atracurium; D009388:Neostigmine; D014673:Vecuronium Bromide