Pyridostigmin (mestinon) as an antagonist of d-tubocurarine.

The effects of pyridostigmin were compared with those of edrophonium and neostigmine in anesthetized patients. Pyridostigmin was superior to edrophonium and equal to neostigmine as an antagonist ofd-tubocurarine. Pyridostigmin produced fewer oropharyngeal secretions and decreased the heart rate less than did neostigmine. Further clinical studies of pyridostigmin should be carried out to confirm or deny this initial favorable experience. It is recommended that adequate recovery from neuromuscular block be defined as return of twitch height to the control level and, more important, the restoration of well sustained tetanus (30 cps.) to the level seen prior to the administration of any neuromuscular blocking agents.