Can Early Administration of Neostigmine, in Single or Repeated Doses, Alter the Course of Neuromuscular Recovery from a Vecuronium-induced Neuromuscular Blockade?

Edrophonium effectively antagonizes neuromuscular block at the laryngeal adductors induced by rapacuronium, rocuronium and cisatracurium, but not mivacurium

“…A bigger dose of anticholinesterase may have had no impact on recovery as even larger doses of edrophonium or neostigmine have been shown to have the same effect on recovery regardless of time of administration. [26][27][28] Whether or not what was observed in this study is applicable to other centrally located neuromuscular units remains to be determined. Certainly the pharmacodynamics of onset of and recovery from nondepolarizing neuromuscular blockade are different in the muscles of respiration when compared to the AP.…”

Edrophonium priming alters the course of neuromuscular recovery from a pipecuronium neuromuscular blockade

“…4-7 They administered the first dose of neostigmine (70 la, g'kg-') during profound vecuronium blockade (no twitch) and the second dose when Tt had recovered to 10% of control value and concluded that repeated administration of neostigmine does not alter the course of recovery. 13 In this study we tried to answer a specific questiondoes administration of edrophonium in divided doses result in a noticeable acceleration of recovery over a single dose of the drug? Rather than using multiple comparisons, we tested the hypothesis directly using Scheffe's linear combination method.…”

Paralisia residual pós-operatória

“…ACAs have several limitations: they depend on the degree of neuromuscular blockade 40 (B); they have adverse effects on different organs and systems due to the antimuscarinic action; they have a ceiling effect 41 (D); they can lead to unpredictable reversal of neuromuscular blockade when used in patients with other comorbidities, or in situations such as hypothermia, or when using certain drugs such as calcium-channel blockers, aminoglycosides and magnesium sulphate 37 (D); and they can promote blockade by desensitization, with increased muscle weakness when used at high doses, or when used after complete recovery of neuromuscular blockade or without previous use of NMB 43 (C), 42,44 (D). They can also decrease the activity of the upper airway dilating muscles, if used after recovery of neuromuscular blockade induced by rocuronium 45 (B).…”

“…They can also decrease the activity of the upper airway dilating muscles, if used after recovery of neuromuscular blockade induced by rocuronium 45 (B). When administered, ACAs should be associated with anticholinergic agents to reduce secondary muscarinic effects, with atropine being the most frequently used 37 (D), 40 …”