Dose-Response Curves for Edrophonium, Neostigmine, and Pyridostigmine after Pancuronium and D-Tubocurarine

Donati, François; McCarroll, S. M.; Antzaka, Christina; McCready, David; Bevan, David R.

doi:10.1097/00132586-198712000-00007

Cited by 12 publications

(23 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For instance, when the reversal was attempted at 10% T1 recovery from cisatracurium block, 4.2 times as much edrophonium as neostigmine was required to achieve 50% T1, but 6.6 times as much is needed to reach a TOF ratio of 0.5 (Tables II, III). In this respect, our results are consistent with our previously published results and those of other investigators [17][18][19][20][21][22][23] who reported similar observations with other non-depolarizing neuromuscular blockers. The reported neostigmine:edrophonium potency ratio for train-of-four, 10 min after injection of the antagonist (following return to 10% first twitch height) was 10.4 for mivacurium, 20 13.5 for atracurium, 22 26 for vecuronium, 18 27.5 for rocuronium, 19 24 for pancuronium and 29 for tubocurarine.…”

Section: Discussionsupporting

confidence: 94%

“…For example, 0.04 mg·kg -1 neostigmine is expected to produce a T1 of 97% and 99% after 10 min if given after atracurium and cisatracurium, respectively (Table IV). Corresponding values noted by others were 95%, 99%, 86%, 77%, and 76% after atracurium, vecuronium, 18 rocuronium, 19 pancuronium, and tubocurarine, 23 respectively. With 0.5 mg·kg -1 edrophonium the corresponding values would be 89%, 86%, 74%, 79%, and 68%, respectively.…”

Section: Discussionsupporting

confidence: 66%

“…The reported neostigmine:edrophonium potency ratio for train-of-four, 10 min after injection of the antagonist (following return to 10% first twitch height) was 10.4 for mivacurium, 20 13.5 for atracurium, 22 26 for vecuronium, 18 27.5 for rocuronium, 19 24 for pancuronium and 29 for tubocurarine. 23 The corresponding potency ratios of atracurium and cisatracurium noted in this study were 13 and 11.8, respectively (Table III). Further, the potency ratio was relatively small shortly after reversal, but the discrepancy between the potencies of neostigmine and edrophonium increased with time.…”

Section: Discussionmentioning

confidence: 51%

“…Corresponding values were 0.67, 0.67, 0.74, 0.60, and 0.49 after atracurium, vecuronium, 18 rocuronium, 19 pancuronium, and tubocurarine, 23 respectively. With 0.5 mg·kg -1 edrophonium the corresponding values would be 0.61, 0.53, 0.51, 0.30, and 0.32, respectively.…”

Section: Discussionmentioning

confidence: 92%

See 3 more Smart Citations

Dose-response relationships for edrophonium and neostigmine antagonism of atracurium and cisatracurium- induced neuromuscular block

Naguib

Riad

2000

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: To study the dose-response relationships for neostigmine and edrophonium during antagonism of neuromuscular block induced by atracurium and cisatracurium. Methods: One hundred and twenty eight, ASA group 1 or 2 adults were given either 0.5 mg·kg -1 atracurium or 0.1 mg·kg -1 cisatracurium during fentanyl-thiopental-nitrous oxide-isoflurane anesthesia. The neuromuscular block was measured by an acceleration-responsive transducer. Responses were defined in terms of percent depression in the first twitch (T1) and train-of-four (TOF) response. When spontaneous recovery of first twitch height reached 10% of its initial control value, edrophonium (0.1, 0.2, 0.4, or 1 mg·kg -1 ) or neostigmine (0.005, 0.01, 0.02, or 0.05 mg·kg -1 ) was administered by random allocation. Neuromuscular function in another sixteen subjects was allowed to recover spontaneously. Results: At five minutes, unlike edrophonium, neostigmine was equally effective against atracurium and cisatracurium with respect to T1 recovery. The neostigmine T1-ED 50 was 10.3 ± 1.06 (SEM) µg·kg -1 after atracurium and 11.2 ± 1.06) µg·kg -1 after cisatracurium. The edrophonium ED 50 was 157 ± 1.07 µg·kg -1 with atracurium and 47.4 ± 1.07 µg·kg -1 with cisatracurium, giving a neostigmine:edrophonium potency ratios of 15.2 ± 1.7 and 4.2 ± 0.41 (P < 0.001) for atracurium and cisatracurium, respectively. At 10 min neostigmine was 13 ± 1.4 times as potent as edrophonium for achieving 50% TOF recovery after atracurium paralysis. After cisatracurium the potency ratio was 11.8 ± 1.3 (NS). Conclusions: Although there were differences at five minutes, neostigmine:edrophonium potency ratios at 10 min, were similar in both relaxants studied.Objectif: Étudier les relations doses-réponses de la néostigmine et de l'édrophonium pendant le renversement du bloc neuromusculaire induit par l'atracurium et le cisatracurium. Méthode : Cent vingt-huit adultes, d'état physique ASA I ou II, ont reçu, soit 0,5 mg·kg -1 d'atracurium, soit 0,1 mg·kg -1 de cisatracurium pendant l'anesthésie au fentanyl-thiopental-protoxyde d'azote-isoflurane. Le bloc neuromusculaire a été mesuré par un transducteur sensible à l'accélération. Les réponses ont été définies en termes de pourcentage de dépression lors de la réponse à la première stimulation (T 1 ) et au train-de-quatre (TDQ). Au moment où la récupération spontanée à la première stimulation a atteint 10 % de la valeur témoin initiale, de l'é-drophonium (0,1; 0,2; 0,4 ou 1 mg·kg -1 ) ou de la néostigmine (0,005; 0,01; 0,02 ou 0,05 mg·kg -1 ) a été administrée selon une affectation aléatoire. Chez seize autres sujets, on a laissé la fonction neuromusculaire se rétablir spontanément. Résultats : À cinq minutes, contrairement à l'édrophonium, la néostigmine a été également efficace contre l'atracurium et le cisatracurium quant à la récupération à T 1 . La T 1 -ED 50 de la néostigmine était de 10,3 ± 1,06 (erreur type) µg·kg -1 après l'atracurium et de 11,2 ± 1,06 µg·kg -1 après le cisatracurium. La ED 50 de l'édropho-nium était de 157 ± 1,0...

show abstract

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 92%

See 2 more Smart Citations

Dose-response relationships for edrophonium and neostigmine antagonism of atracurium and cisatracurium- induced neuromuscular block

Naguib

Riad

2000

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…The ED9s is [25][26][27][28][29][30] Ixg" kg-t. it has a very slow onset to maximum blockade at subparalysing doses (10-13 min). The duration of clinical anaesthesia following 2 x ED95 doses of 90-120 min is similar to pancuronium as is the recovery index (recovery time from 25 to 75% twitch activity) of 30-50 min.…”

Section: Doxacuriummentioning

confidence: 99%