Impaired neostigmine antagonism of pancuronium during enflurane anaesthesia in man
Delisle, S.; Bevan, D.R.
British Journal of Anaesthesia 54(4): 441-445
1982
ISSN/ISBN: 0007-0912 PMID: 7066141 Document Number: 195524
The rates of recovery of pancuronium-induced neuromuscular blockade after administration of neostigmine were compared during anesthesia maintained with N2O and intermittent narcotics, halothane or enflurane. Patients [30] were studied in whom anesthesia was maintained with 70% N2O in O2 with fentanyl or thiopentone, halothane (0.55-0.65% end-tidal) or enflurane (1.3-1.4% end-tidal). Muscle twitch response was measured using train-of-4 stimulation. Pancuronium 3 mg/70 kg was antagonized with neostigmine 2.5 mg/70 kg at 10% spontaneous recovery of the 1st twitch of the train compared with control. There were no significant differences between the times to 10% spontaneous recovery of the 1st twitch or the rates of train-of-4 recovery after neostigmine when the narcotic and halothane groups were compared. Enflurane anesthesia in comparisons with fentanyl, was associated with a significant increase in the time to 10% recovery (57.9 .+-. 6.0 vs. 35.4 .+-. 7.0 min) and with decreases in the train-of-4 recoveries at 4, 5, 10, 20 and 30 min after nesotigmine. Evidently, the antagonism of pancuronium-induced neuromuscular blockade with neostigmine was impaired during enflurane, but not halothane, anesthesia.