Antagonism of vecuronium-induced neuromuscular blockade with edrophonium or neostigmine.

Antagonism of vecuronium-induced neuromuscular blockade was attempted, at varying degrees of spontaneous recovery, with edrophonium 0.5 mg kg-1 or neostigmine 0.05 mg kg-1 in two groups of 20 patients. Neuromuscular blockade was monitored using a train-of-four (TOF) stimulation. Adequate antagonism of neuromuscular blockade, defined as a sustained TOF ratio of 0.7 or more, was attained in all 20 patients given neostigmine and in 13 out of 20 given edrophonium. Five of the remaining seven patients given edrophonium had shown three or less responses to TOF stimulation before antagonism. While the time to onset of the action of edrophonium (22 s) was not significantly shorter than neostigmine (26 s), the time taken to attain a TOF ratio of 0.7 was significantly shorter with edrophonium (67 s compared with 194 s with neostigmine). It is concluded that edrophonium 0.5 mg kg-1 does not consistently antagonize vecuronium-induced neuromuscular blockade, particularly if there are three or less responses to a TOF stimulation present before antagonism.

[1]  C. J. Jones,et al.  Antagonism of neuromuscular blockade , 1988, Anaesthesia.

[2]  J. Engbaek,et al.  Edrophonium and neostigmine for reversal of the neuromuscular blocking effect of vecuronium. , 1986, Acta anaesthesiologica Scandinavica.

[3]  R. Mirakhur.  Antagonism of the muscarinic effects of edrophonium with atropine or glycopyrrolate. A comparative study. , 1985, British journal of anaesthesia.

[4]  G. Lavery,et al.  A Comparison of Edrophonium and Neostigmine for the Antagonism of Atracurium‐Induced Neuromuscular Block , 1985, Anesthesia and analgesia.

[5]  F. Donati,et al.  The potencies of edrophonium and neostigmine as antagonists of pancuronium , 1985, Anaesthesia.

[6]  Ronald D. Miller,et al.  NEOSTIGMINE ANTAGONIZES A PROFOUND NEUROMUSCULAR BLOCKADE MORE RAPIDLY THAN EDROPHONIUM , 1984 .

[7]  J. Williams,et al.  Recovery characteristics following antagonism of atracurium with neostigmine or edrophonium. , 1984, British journal of anaesthesia.

[8]  F. Donati,et al.  Twitch Depression and Train‐of–Four Ratio after Antagonism of Pancuronium with Edrophonium, Neostigmine, or Pyridostigmine , 1983, Anesthesia and analgesia.

[9]  R. Miller,et al.  Edrophonium: Duration of Action and Atropine Requirement in Humans during Halothane Anesthesia , 1982, Anesthesiology.

[10]  W. Kerr,et al.  Some actions of Org NC 45 and of edrophonium in the anaesthetized cat and in man. , 1982, British journal of anaesthesia.

[11]  H. H. Ali,et al.  Twitch, Tetanus and Train‐of‐Four as Indices of Recovery from Nondepolarizing Neuromuscular Blockade , 1981, Anesthesiology.

[12]  Aaron F. Kopman.  Edrophonium Antagonism of Pancuronium‐induced Neuromuscular Blockade in Man: A Reappraisal , 1979, Anesthesiology.

[13]  D. Bevan.  Reversal of pancuronium with edrophonium , 1979, Anaesthesia.

[14]  H. H. Ali,et al.  Monitoring of neuromuscular function , 1987, International journal of clinical monitoring and computing.