85749
document
Neostigmine and edrophonium antagonism of moderate neuromuscular block induced by pancuronium or tubocurarine . Edrophonium and neostigmine are anticholinesterase drugs used commonly to antagonize competitive neuromuscular block . Although it has a faster onset of action than neostigmine , edrophonium is unreliable when used to antagonize deep neuromuscular block . We have compared the antagonist characteristics of these two drugs when used to antagonize a moderate degree of pancuronium- or tubocurarine-induced neuromuscular block . Forty ASA I or II patients undergoing surgical procedures were allocated randomly to receive either pancuronium 70 micrograms kg-1 or tubocurarine 0.5 mg kg-1 , and to receive either edrophonium 0.5 mg kg-1 or neostigmine 0.05 mg kg-1 . Antagonism was attempted when the first response to train-of-four ( TOF ) stimulation recovered spontaneously to 25 % of the control height . Neuromuscular function was monitored using the evoked integrated electromyogram of the first dorsal interosseous muscle of the hand . Adequate recovery was defined as the achievement of a TOF ratio of 0.70 or greater . Only seven of 20 patients who received edrophonium demonstrated adequate recovery 30 min after antagonism . Under the conditions described in this study , edrophonium 0.5 mg kg-1 was less effective as an antagonist than neostigmine 0.05 mg kg-1 .
85750
Intervention_Pharmacological
Neostigmine
85751
Intervention_Pharmacological
edrophonium
85752
Intervention_Pharmacological
Edrophonium
85753
Intervention_Pharmacological
neostigmine
85754
Intervention_Pharmacological
neostigmine
85755
Intervention_Pharmacological
edrophonium
85756
Intervention_Pharmacological
allocated randomly to receive either pancuronium 70 micrograms kg-1 or tubocurarine 0.5 mg kg-1 , and to receive either edrophonium 0.5 mg kg-1 or neostigmine 0.05 mg kg-1
85757
Outcome_Physical
neuromuscular block .
85758
Outcome_Physical
neuromuscular block .
85759
Outcome_Physical
Neuromuscular function
85760
Outcome_Other
evoked integrated electromyogram
85761
Participant_Sample-size
Forty
85762
Participant_Condition
ASA
85763
Participant_Condition
undergoing surgical procedures
85764
Participant_Sample-size
20