Neuromuscular and cardiovascular effects of neostigmine and methyl-atropine administered at different degrees of rocuronium-induced neuromuscular block.
The neuromuscular and cardiovascular effects of neostigmine, 40 micrograms kg-1, and methyl-atropine, 7 micrograms kg-1, administered at different degrees of rocuronium-induced (600 micrograms kg-1) neuromuscular block were evaluated. In one group of patients spontaneous recovery was awaited (Group A; n = 20). Neostigmine and methyl-atropine were administered 2 minutes after rocuronium (Group B; n = 20) or at 25% twitch recovery (Group C; n = 20). Neuromuscular transmission was monitored mechanomyographically. Data are presented as mean (SD) [95%-CI]. The initial rate of recovery (time until a TOF ratio of 0.2) in group B, i.e. 14.2 (4.5) [12.1-16.3] min, was significantly faster than in group C, i.e. 28.7 (5.3) [26.3-31.1] min. However, the time until clinically sufficient recovery (time until a TOF ratio of 0.7) was similar for groups B, i.e. 29.3 (9.5) [24.9-33.7] min and group C, i.e. 31.8 (5.6) [29.2-34.4] min, both significantly different from that of group A, i.e. 53.2 (14.5) [46.5-59.9] min. The increase in heart rate following neostigmine/methyl-atropine was more pronounced in the group reversed at 2 min after rocuronium (P < 0.01).
Research Group for Experimental Anesthesiology and Clinical Pharmacology, University of Groningen, The Netherlands.
L
L
Van den Broek
J H
JH
Proost
J M
JM
Wierda
M D
MD
Njoo
P J
PJ
Hennis
D000328:Adult; D000732:Androstanols / Q000008:administration & dosage / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D000762:Anesthesia Recovery Period; D001286:Atropine Derivatives / Q000008:administration & dosage / Q000494:pharmacology*; D004338:Drug Combinations; D004558:Electric Stimulation; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000187:drug effects; D018482:Muscle, Skeletal / Q000187:drug effects / Q000294:innervation; D009388:Neostigmine / Q000008:administration & dosage / Q000494:pharmacology*; D009469:Neuromuscular Junction / Q000187:drug effects*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D010276:Parasympatholytics / Q000008:administration & dosage / Q000494:pharmacology*; D000077123:Rocuronium; D009435:Synaptic Transmission / Q000187:drug effects; D014459:Ulnar Nerve / Q000187:drug effects
D000732:Androstanols; D001286:Atropine Derivatives; D004338:Drug Combinations; D003473:Neuromuscular Nondepolarizing Agents; D010276:Parasympatholytics; D009388:Neostigmine; C006649:methylatropine; D000077123:Rocuronium