Neostigmine antagonism of succinyl-choline phase II block: A comparison with pancuronium |
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Authors: | Malcolm E. Futter François Donati David R. Bevati |
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Affiliation: | 1. Departments of Anaesthesia, Royal Victoria Hospital & McGill University, 687 Pine Avenue West, H3A 1A1, Montreal, Quebec
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Abstract: | To assess the efficacy of neostigmine antagonism of succinylcholine phase II block, succinylcholine infusions were given to 17 patients for durations varyingfrom 44 to 192 minutes. A control group (17 patients) received a pancuronium infusion for similar times. Ninety per cent neuromuscular block was maintained in these two groups by adjustment of the infusion rates and, in a third group, with intermittent doses of pancuronium. Neuromuscular transmission was monitored with train-of-four stimulation every 12 seconds and anaesthesia was maintained with N2O-02-enfiurane. Ten minutes after the infusion was stopped, atropine and neostigmine were given to all patients who received pancuronium and to 11 patients in the succinylcholine group whose train-of-four ratio (T4IT1) was less than 0.7, During the subsequent 15 minutes, recovery was more rapid in the succinylcholine group than in either the pancuronium-infusion or pan-curonium-bolus groups. It is concluded that succinyl-choline-induced phase II block can be safely and rapidly antagonized with neostigmine. |
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