Neuromuscular and cardiovascular effects of neostigmine and methyl-atropine administered at different degrees of rocuronium-induced neuromuscular block
Van den Broek, L.; Proost, J.H.; Wierda, J.M.; Njoo, M.D.; Hennis, P.J.
European Journal of Anaesthesiology 11(6): 481-487
1994
ISSN/ISBN: 0265-0215 PMID: 7851356 Document Number: 436360
The neuromuscular and cardiovascular effects of neostigmine, 40 mu-g kg-1, and methyl-atropine, 7 mu-g kg-1, administered at different degrees of rocuronium-induced (600 mu-g kg-1) neuromuscular block were evaluated. In one group of patients spontaneous recovery was awaited (Group A; n=20). Neostigmine and methyl-atropine were administered 2 minutes after rocuronium (Group B; n = 20) or at 25% twitch recovery (Group C; n=20). Neuromuscular transmission was monitored mechanomyographically. Data are presented as mean (SD) (95%-CI). The initial rate of recovery (time until a TOF ratio of 0.2) in group B, i.e. 14.2 (4.5) (12.1-16.3) min, was significantly faster than in group C, i.e. 28.7 (5.3) (26.3-31.1) min. However, the time until clinically sufficient recovery (time until a TOF ratio of 0.7) was similar for groups B, i.e. 29.3 (9.5) (24.9-33.7) min and group C, i.e. 31.8 (5.6) (29.2-34.4) min, both significantly different from that of group A, i.e. 53.2 (14.5) (46.5-59.9) min.The increase in heart rate following neostigmine/methyl-atropine was more pronounced in the group reversed at 2 min after rocuronium (P lt 0.01). from strict continuous presence of the anaesthesiologist to observation of the patient by a nonmedical assistant and the anaesthesiologist taking care of another anaesthetized patient. Items which all standards should mention are defined.