title: Halogenated vapor anesthetics adversely influence edrophonium reversal.
abstract: Reversal of the pancuronium induced neuromuscular block by edrophonium was studied in different groups of male surgical patients. All groups received similar premedication and identical induction of anesthesia. Neuromuscular function was monitored by the transduced response of the thumb adductor muscle to different [e.g. 0.2, 2 and 50 counts per second (cps)] supramaximal electrical stimuli applied to the ulnar nerve. When the regimen of anesthesia maintenance included halogenated vapor anesthetics the reversal of neuromuscular block was of lesser degree than in the case of N2O/O2 + fentanyl anesthesia. The reversal of the "fade-type" (e.g. tetanic and "train of four") responses was particularly incomplete with halothane and isoflurane. Compared with edrophonium, pyridostigmine was found to be more effective under halothane anesthesia. Based on these results, edrophonium may not be the first choice in the clinical reversal of deep levels of nondepolarizing neuromuscular block in the presence of vapor anesthetics.
authors.affiliation: Department of Anesthesia, Veterans Administration Medical Center, Albuquerque, NM 87108.
authors.forename: L
authors.initials: L
authors.lastname: Gyermek
mesh_terms: D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D000777:Anesthetics / Q000009:adverse effects*; D004347:Drug Interactions; D004491:Edrophonium / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010197:Pancuronium / Q000037:antagonists & inhibitors; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D012151:Resuscitation
chemical_list: D000777:Anesthetics; D004491:Edrophonium; D010197:Pancuronium; D011729:Pyridostigmine Bromide