Korean J Anesthesiol.  1996 Jun;30(6):711-714. 10.4097/kjae.1996.30.6.711.

The Effect of Neostigmine on the Train-of-four Ratio during the Recovery from Vecuronium- or Atracurium-induced Neuromuscular Blockade

• Shim YJ
• Kim SI
• Kim SC
• Park W
• Kim SY

• KMID: 1934803
• DOI: http://doi.org/10.4097/kjae.1996.30.6.711

Abstract

BACKGROUND: The train-of-four(TOF) fade known as expression of prejuntional receptor binding was useful for evaluating the residual neuromuscular blockade(NMB). The present study was undertaken to investigate the effect of the neostigmine(Neo) on TOF ratio during the recovery from vecuronium(V) or atracurium(A) induced NMB under the general anesthesia.
METHODS
Forty healthy adult patients were randomly divided into 4 groups as follows; spontaneous recovery from V-induced NMB(V-C group) or A-induced NMB(A-C group), reversed recovery with Neo at 20% recovery of control first twitch height(T) from V-induced NMB(V-R group) or A-induced NMB(A-R group). TOF ratio at 25 and 75% recovery of T and recovery index(RI) defined as time from 25 to 75% recovery of T were measured.
RESULTS
TOF ratios at 25 and 75% recovery of T were 3.7 & 35.8%(V-C group), 8.4 & 46.9%(A-C group), 3.7 & 48.7%(V-R group) and 15.2 & 55.6%(A-R group) respectively(P>0.05). RI were 19.2 min(V-C group), 19.5 min(A-C group), 3.5 min(V-R group), and 5.6 min(A-R group) respectively (P<0.05).
CONCLUSIONS
RI were significantly shortened in reversed recovery groups with Neo than spontaneous recovery groups (P<0.05). However TOF ratio at 75% recovery of T1 were not significantly different between spontaneous recovery and reversed recovery groups.

Keyword

Neuromuscular relaxant; vecuronium; atracurium; Antagonist; neuromuscular relaxants; neostigmine; Neuromuscular transmission; TOF ratio

MeSH Terms

Adult
Anesthesia, General
Atracurium
Humans
Neostigmine*
Neuromuscular Blockade*
Vecuronium Bromide
Atracurium
Neostigmine
Vecuronium Bromide