Administration of depolarizing muscle relaxants after non-depolarizer reversal: when is it safe?
In the light of studies on the duration of action and pharmacokinetics of intravenous neostigmine, it is recommended that, depending upon the dosage administered, at least 1 hour should elapse before a depolarizer can safely be given after neuromuscular reversal with neostigmine, and at least 90 - 120 minutes after reversal with physostigmine. It is suggested that a diluted test dose of depolarizer be given first, and its effect monitored with a peripheral nerve stimulator because fasciculations will not occur.
D000770:Anesthesia, Endotracheal / Q000379:methods; D004347:Drug Interactions; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D009388:Neostigmine / Q000008:administration & dosage*; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D010525:Peripheral Nerves / Q000502:physiology; D010830:Physostigmine / Q000008:administration & dosage; D013390:Succinylcholine / Q000008:administration & dosage*; D013997:Time Factors
D009467:Neuromuscular Depolarizing Agents; D009388:Neostigmine; D010830:Physostigmine; D013390:Succinylcholine