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Canadian Journal of Anesthesia, Vol 33, 723-728, Copyright © 1986 by Canadian Anesthesiologists' Society

Accelerated Reversal of Atracurium Blockade With Divided Doses of Neostigmine

MOHAMED ABDULATIF MB BCH M SC1 and MOHAMED NAGUIB MB BCH MSC FFARCSI1

1 Department of Anaesthesiology, King Faisal University, King Fahd Hospital, P.O. Box 2208, Al-Khobar 31952, Saudi Arabia

Address correspondence to: Dr. M. Naguib.

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 (TOF) 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.

Key Words: NEUROMUSCULAR RELAXANTS: atracurium • ANTAGONISTS, NEUROMUSCULAR RELAXANTS: neostigmine • NEUROMUSCULAR TRANSMISSION: train-of-four






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Copyright © 1986 by the Canadian Anesthesiologists' Society.