Abstract
The hypothesis that administration of neostigmine in divided doses might accelerate the antagonism of neuromuscular blockade was investigated. Neostigmine 0.05 mg.kg-1 was administered either in a single bolus dose (Group I, n = 16) or in an initial dose of 0.01 mg-kg-1 followed three minutes later by 0.04 mg-kg-1 (Group II, n = 16) for antagonism of atracurium-induced blockade. Reversal was attempted at 10 per cent spontaneous recovery of twitch height. The mean time (±SD)from the first injection of the drug until the train-of-four (TOFj ratio value had reached 0.75 was significantly shorter in Group II (p < 0.05) than in Group I (391.8 ± 83.3 and 468.6 ± 150.3 seconds respectively). The rate of TOF ratio recovery was 2.5 times faster after neostigmine administration in divided doses.
It is concluded that administration of neostigmine in divided doses, as described in this study, produced a significantly faster reversal of residual atracurium-induced neuromuscular blockade as compared to a single bolus administration.
Résumé
L’hypothèse que l’administration de neostigmine à doses divisées peut accélérer l’antagonisme du block neuromusculaire était investiguée. La néostigmine 0.05 mgkg-1 était administrée soit en bolus unique (Group I, n = 16) ou en une dose initiale de 0.01 mg.kg-1 suivi trois minutes plus tard de 0.04 mg.kg-1 (Group 11, n = 16) pour l’antagonisme d’un block induit par l’atracurium. Le renversement du block était tenté lorsqu’on a observé le recouvrement spontané de dix pour cent dans la hauteur de twitch. Le temps moyen ( ± SD) à partir de la première injection du médicament jusqu’à l’obtention d’une ondée de quatre (TOF) de 75 pour cent était significativement plus cour dans le groupe II (p < 0.05) que dans le Groupe I (391.8 ± 83.3 et 468.6 ± 150.3 secondes respectivement). Le taux de recouvrement de l’ondée de quatre (TOF) était 2.5 fois plus rapide après l’administration de neostigmine à dose divisée.
On conclue que l’administration de néostigmine à doses divisées, telle que décrites dans cette étude, produit un antagonisme significativement plus rapide du block neuromusculaire induit par l’atracurium comparativement à l’administration de la néostigmine en un bolus unique.
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Abdulatif, M., Naguib, M. Accelerated reversal of atracurium blockade with divided doses of neostigmine. Can Anaesth Soc J 33, 723–728 (1986). https://doi.org/10.1007/BF03027121
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DOI: https://doi.org/10.1007/BF03027121