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Neostigmine antagonism of rocuronium block during anesthesia with sevoflurane, isoflurane or propofol.
Can J Anaesth. 2001 Apr; 48(4):351-5.CJ

Abstract

PURPOSE

To examine the influence of continuing administration of sevoflurane or isoflurane during reversal of rocuronium induced neuromuscular block with neostigmine.

METHODS

One hundred and twenty patients, divided into three equal groups, were randomly allocated to maintenance of anesthesia with sevoflurane, isoflurane or propofol. Neuromuscular block was induced with rocuronium and monitored using train-of-four (TOF) stimulation of the ulnar nerve and recording the force of contraction of the adductor pollicis muscle. Neostigmine was administered when the first response in TOF had recovered to 25%. At this time the volatile agent administration was stopped or propofol dosage reduced in half the patients in each group (n = 20 in each group). The times to attain TOF ratio of 0.8, and the number of patients attaining this end point within 15 min were recorded.

RESULTS

The times (mean +/- SD) to recovery of the TOF ratio to 0.8 were 12.0 +/- 5.5 and 6.8 +/- 2.3 min in the sevoflurane continued and sevoflurane stopped groups, 9.0 +/- 8.3 and 5.5 +/- 3.0 min in the isoflurane continued and isoflurane stopped groups, and 5.2 +/- 2.8 and 4.7 +/- 1.5 min in the propofol continued and propofol stopped groups (P < 0.5-01). Only 9 and 15 patients in the sevoflurane and isoflurane continued groups respectively had attained a TOF ratio of 0.8 within 15 min (P < 0.001 for sevoflurane).

CONCLUSIONS

The continued administration of sevoflurane, and to a smaller extent isoflurane, results in delay in attaining adequate antagonism of rocuronium induced neuromuscular block.

Authors+Show Affiliations

Department of Anaesthetics and Intensive Care Medicine, The Queen's University of Belfast, N. Ireland, UK.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11339776

Citation

Reid, J E., et al. "Neostigmine Antagonism of Rocuronium Block During Anesthesia With Sevoflurane, Isoflurane or Propofol." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 48, no. 4, 2001, pp. 351-5.
Reid JE, Breslin DS, Mirakhur RK, et al. Neostigmine antagonism of rocuronium block during anesthesia with sevoflurane, isoflurane or propofol. Can J Anaesth. 2001;48(4):351-5.
Reid, J. E., Breslin, D. S., Mirakhur, R. K., & Hayes, A. H. (2001). Neostigmine antagonism of rocuronium block during anesthesia with sevoflurane, isoflurane or propofol. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 48(4), 351-5.
Reid JE, et al. Neostigmine Antagonism of Rocuronium Block During Anesthesia With Sevoflurane, Isoflurane or Propofol. Can J Anaesth. 2001;48(4):351-5. PubMed PMID: 11339776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neostigmine antagonism of rocuronium block during anesthesia with sevoflurane, isoflurane or propofol. AU - Reid,J E, AU - Breslin,D S, AU - Mirakhur,R K, AU - Hayes,A H, PY - 2001/5/8/pubmed PY - 2001/9/8/medline PY - 2001/5/8/entrez SP - 351 EP - 5 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 48 IS - 4 N2 - PURPOSE: To examine the influence of continuing administration of sevoflurane or isoflurane during reversal of rocuronium induced neuromuscular block with neostigmine. METHODS: One hundred and twenty patients, divided into three equal groups, were randomly allocated to maintenance of anesthesia with sevoflurane, isoflurane or propofol. Neuromuscular block was induced with rocuronium and monitored using train-of-four (TOF) stimulation of the ulnar nerve and recording the force of contraction of the adductor pollicis muscle. Neostigmine was administered when the first response in TOF had recovered to 25%. At this time the volatile agent administration was stopped or propofol dosage reduced in half the patients in each group (n = 20 in each group). The times to attain TOF ratio of 0.8, and the number of patients attaining this end point within 15 min were recorded. RESULTS: The times (mean +/- SD) to recovery of the TOF ratio to 0.8 were 12.0 +/- 5.5 and 6.8 +/- 2.3 min in the sevoflurane continued and sevoflurane stopped groups, 9.0 +/- 8.3 and 5.5 +/- 3.0 min in the isoflurane continued and isoflurane stopped groups, and 5.2 +/- 2.8 and 4.7 +/- 1.5 min in the propofol continued and propofol stopped groups (P < 0.5-01). Only 9 and 15 patients in the sevoflurane and isoflurane continued groups respectively had attained a TOF ratio of 0.8 within 15 min (P < 0.001 for sevoflurane). CONCLUSIONS: The continued administration of sevoflurane, and to a smaller extent isoflurane, results in delay in attaining adequate antagonism of rocuronium induced neuromuscular block. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/11339776/Neostigmine_antagonism_of_rocuronium_block_during_anesthesia_with_sevoflurane_isoflurane_or_propofol_ L2 - https://doi.org/10.1007/BF03014962 DB - PRIME DP - Unbound Medicine ER -