Early and late reversibility of rocuronium bromide.
A computer simulation has been developed based on pharmacodynamic-pharmacokinetic modelling of the effect of neostigmine on rocuronium-induced neuromuscular blockade. The results of a previous study involving 60 patients were used as a test of the model. The model predicts that administration of neostigmine 40 micrograms kg-1 within 20 min of the administration of rocuronium does not decrease the duration of the block until 90% recovery has taken place. The optimum dose of neostigmine depends on the degree of block at the time of administration: for a more intense block the optimum dose is 80 micrograms kg-1 and for a less intense block is about 30 micrograms kg-1. The pharmacokinetic behaviour rather than the potency of the relaxant determines its reversibility.
van den Broek
L
L
Research Group for Experimental Anesthesiology and Clinical Pharmacology, University Hospital Groningen, The Netherlands.
Proost
J H
JH
Wierda
J M
JM
D000732:Androstanols / Q000037:antagonists & inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology*; D003198:Computer Simulation; D006801:Humans; D009119:Muscle Contraction / Q000187:drug effects; D009388:Neostigmine / Q000008:administration & dosage* / Q000494:pharmacology; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology*; D000077123:Rocuronium; D013997:Time Factors
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D009388:Neostigmine; D000077123:Rocuronium