Abstract
The effect of different priming doses of edrophonium were studied in 77 patients divided into seven groups (n = 11 in each). Edrophonium 1.0 mg-kg-1 was administered either in a single bolus dose (Group I; controls) or in an initial dose of 0.05, 0.1, 0.15, 0.2, 0.25 or 0.3 mg-kg-1 followed one minute later by the remainder of the 1.0 mg-kg-1 dose in Groups II to VII respectively. Reversal was attempted at ten per cent spontaneous recovery of twitch height (TI) from atracurium-induced neuromuscular blockade. Increasing the size of the priming dose from 0.05 to 0.2 mg-kg-1 resulted in a stepwise increase (p < 0.05) in recovery of TI and train-of-four (TOF) ratio. Higher priming doses (0.25 and 0.3 mg-kg-1) were not associated with further improvement in TI and TOF recovery. Reversal time, that is the time taken from the first injection of edrophonium until the TOF ratio value had reached 0.75 was significantly faster (p < 0.01) following priming with edrophonium 0.2 mg-kg-1 (Group V) when compared to Groups I, II, III, IV and VI. Reversal times were also significantly faster in Groups IV and VI when compared to the control group.
It is concluded that 0.2 mg-kg-1 appears to be the optimal priming dose for administration of edrophonium in divided doses.
Résumé
Ľeffet de différentes doses ďamorce ďédrophonium a été étudié chez 77 patients divisés en sept groupes (n = 11). Ľédrophonium 1.0 mg-kg-1 a été administré soit en une dose unique (Groupe I, contrôle) ou en une dose initiale de 0.05, 0.1, 0.15, 0.2, 0.25 ou 0.3 mg-kg-1 suivi une minute plus tard par le restant de la dose de 1.0 mg-kg-1 pour les Groupes II à VII. Ľantagonisme a été tenté après une récupération spontanée à dix pour cent de la hauteur de twitch (TI) après un bloc neuromusculaire induit par ľatracurium. Ľaugmentation de la dose ďamorce de 0.05 à 0.2 mg-kg-1 a produit une augmentation de plus en plus accrue (p < 0.05) dans la récupération de TI et du rapport de ľondée-de-quatre (TOF). La plus grande dose ďamorce (0.25 et 0.3 mg-kg-1) n’était pas associée avec de plus grandes améliorations dans la récupération de TI et TOF. Le temps ďantagonisme, qui représente le temps du début de la première injection ďédrophonium jusqu’à ľobtention ďun rapport de TOF de 0.75 était significativement plus rapide (p < 0.01) après la dose ďamorce ďédrophonium de 0.2 mg-kg-1 Groupe V) en comparaison Groupe I, II, III, IV et VI. Les temps ďantagonisation étaient aussi significativement plus rapides dans les groupes IV et VI comparativement groupe contrôle. On conclut que la dose de 0.1 mg-kg-1 apparaît optimale comme dose ďamorce pour ľadministration de ľédrophonium en doses fractionnées.
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Naguib, M., Abdulatif, M. Priming with anticholinesterases — the effect of different priming doses of edrophonium. Can J Anaesth 35, 53–57 (1988). https://doi.org/10.1007/BF03010545
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DOI: https://doi.org/10.1007/BF03010545