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Optimum dose of neostigmine to reverse shallow neuromuscular blockade with rocuronium and cisatracurium.
Anaesthesia. 2016 Apr; 71(4):443-9.A

Abstract

We examined the use of neostigmine for reversing shallow (defined as train-of-four ratio of 0.5), cisatracurium- and rocuronium-induced neuromuscular block in 112 patients, by use of 0 μg.kg(-1) , 10 μg.kg(-1) , 20 μg.kg(-1) or 40 μg.kg(-1) dose of neostigmine for reversal. The times from neostigmine administration to train-of-four ratios of 0.7, 0.9 and 1.0 were evaluated. Analysis of variance showed that the duration of action was significantly longer after cisatracurium compared with rocuronium. The time to reach a train-of-four ratio of 1.0 was significantly shorter with neostigmine 40 μg.kg(-1) compared with lower neostigmine doses, and at this dose the time did not differ between cisatracurium and rocuronium. The recovery time from a train-of-four ratio of 0.5-1.0 did not differ between cisatracurium and rocuronium, and was significantly shortened by the administration of neostigmine. We conclude that a neostigmine dose of 40 μg.kg(-1) was the most effective at reducing recovery time after neuromuscular blockade.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Sungnam-si, Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Sungnam-si, Korea.Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Sungnam-si, Korea.Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Sungnam-si, Korea.Department of Anesthesiology and Pain Medicine, Inha University Hospital, Incheon, Korea.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26874258

Citation

Choi, E S., et al. "Optimum Dose of Neostigmine to Reverse Shallow Neuromuscular Blockade With Rocuronium and Cisatracurium." Anaesthesia, vol. 71, no. 4, 2016, pp. 443-9.
Choi ES, Oh AY, Seo KS, et al. Optimum dose of neostigmine to reverse shallow neuromuscular blockade with rocuronium and cisatracurium. Anaesthesia. 2016;71(4):443-9.
Choi, E. S., Oh, A. Y., Seo, K. S., Hwang, J. W., Ryu, J. H., Koo, B. W., & Kim, B. G. (2016). Optimum dose of neostigmine to reverse shallow neuromuscular blockade with rocuronium and cisatracurium. Anaesthesia, 71(4), 443-9. https://doi.org/10.1111/anae.13398
Choi ES, et al. Optimum Dose of Neostigmine to Reverse Shallow Neuromuscular Blockade With Rocuronium and Cisatracurium. Anaesthesia. 2016;71(4):443-9. PubMed PMID: 26874258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimum dose of neostigmine to reverse shallow neuromuscular blockade with rocuronium and cisatracurium. AU - Choi,E S, AU - Oh,A Y, AU - Seo,K S, AU - Hwang,J W, AU - Ryu,J H, AU - Koo,B W, AU - Kim,B G, Y1 - 2016/02/13/ PY - 2016/01/06/accepted PY - 2016/2/14/entrez PY - 2016/2/14/pubmed PY - 2016/8/6/medline SP - 443 EP - 9 JF - Anaesthesia JO - Anaesthesia VL - 71 IS - 4 N2 - We examined the use of neostigmine for reversing shallow (defined as train-of-four ratio of 0.5), cisatracurium- and rocuronium-induced neuromuscular block in 112 patients, by use of 0 μg.kg(-1) , 10 μg.kg(-1) , 20 μg.kg(-1) or 40 μg.kg(-1) dose of neostigmine for reversal. The times from neostigmine administration to train-of-four ratios of 0.7, 0.9 and 1.0 were evaluated. Analysis of variance showed that the duration of action was significantly longer after cisatracurium compared with rocuronium. The time to reach a train-of-four ratio of 1.0 was significantly shorter with neostigmine 40 μg.kg(-1) compared with lower neostigmine doses, and at this dose the time did not differ between cisatracurium and rocuronium. The recovery time from a train-of-four ratio of 0.5-1.0 did not differ between cisatracurium and rocuronium, and was significantly shortened by the administration of neostigmine. We conclude that a neostigmine dose of 40 μg.kg(-1) was the most effective at reducing recovery time after neuromuscular blockade. SN - 1365-2044 UR - https://www.unboundmedicine.com/medline/citation/26874258/Optimum_dose_of_neostigmine_to_reverse_shallow_neuromuscular_blockade_with_rocuronium_and_cisatracurium_ L2 - https://doi.org/10.1111/anae.13398 DB - PRIME DP - Unbound Medicine ER -