Recovery characteristics following antagonism of atracurium with neostigmine or edrophonium.
The evoked reversal characteristics of atracurium were studied in 21 patients using edrophonium or neostigmine and a train-of-four pattern of stimulation. Reversal of residual atracurium -induced neuromuscular blockade was significantly more rapid using edrophonium compared with neostigmine. The ratio of the fourth twitch in the train-of-four to the first twitch--the T4 ratio--was significantly greater when the first twitch (T1) had recovered to 75% of control T1, using edrophonium compared with neostigmine. A T4 ratio of 0.5 was confirmed to be compatible with the reliable and safe reversal of atracurium -induced neuromuscular blockade.
D000328:Adult; D001279:Atracurium; D004491:Edrophonium / Q000494:pharmacology*; D006801:Humans; D007546:Isoquinolines / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D009119:Muscle Contraction / Q000187:drug effects; D009388:Neostigmine / Q000494:pharmacology*; D009466:Neuromuscular Blocking Agents / Q000037:antagonists & inhibitors*; D009469:Neuromuscular Junction / Q000502:physiology; D011897:Random Allocation; D009435:Synaptic Transmission / Q000187:drug effects; D013997:Time Factors
D007546:Isoquinolines; D009466:Neuromuscular Blocking Agents; D001279:Atracurium; D009388:Neostigmine; D004491:Edrophonium