title: Reversal of pipecuronium bromide with pyridostigmine.
abstract: Pipecuronium Bromide (Arduan, Organon, Inc, West Orange) is a long-acting, nondepolarizing neuromuscular blocking agent. The efficacy of pyridostigmine 170 micrograms/kg intravenously (approximately 10 mg/70 kg) for reversing pipecuronium has not been reported. This study was performed to determine the time required to obtain a train-of-four (TOF) ratio of 0.7 after administration of pyridostigmine 140 micrograms/kg at 25% recovery of T1 after pipecuronium-induced neuromuscular blockade. Sixteen, American Society of Anesthesiology (ASA) I or II patients undergoing surgical procedures of at least 90 minutes, requiring intubation and muscle relaxation were included. Neuromuscular blockade was assessed using the Puritan-Bennett/Datex NMT 221 placed for ulnar nerve stimulation. Anesthesia was maintained with a nitrous oxide/narcotic technique and the use of potent inhalational anesthetics was avoided. The mean reversal time was found to be 16.14 minutes, with a minimum of 10.3 minutes and a maximum of 24.3 minutes. The standard error was +/- 1.05 minutes with a variance of 17.68 minutes.
authors.forename: R M
authors.initials: RM
authors.lastname: Alisoglu
authors.forename: J
authors.initials: J
authors.lastname: Nagelhout
authors.forename: J V
authors.initials: JV
authors.lastname: Kyff
authors.forename: S
authors.initials: S
authors.lastname: Perov
authors.forename: P W
authors.initials: PW
authors.lastname: Santoro
authors.forename: J
authors.initials: J
authors.lastname: Scarsella
mesh_terms: D000328:Adult; D004558:Electric Stimulation; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D009407:Nerve Block / Q000379:methods*; D009431:Neural Conduction; D017300:Pipecuronium / Q000627:therapeutic use*; D011729:Pyridostigmine Bromide / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D017300:Pipecuronium; D011729:Pyridostigmine Bromide