Time to peak effect of neostigmine at antagonism of atracurium- or vecuronium-induced neuromuscular block

Kirkegaard-Nielsen, Hans; Helbo-Hansen, Hans S.; Lindholm, Peter; Severinsen, Inge Krogh; Bülow, Karsten

doi:10.1016/0952-8180(95)00088-7

Cited by 22 publications

(12 citation statements)

References 27 publications

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“…Kirkegaard-Nielsen et al [25] demonstrated that the time to the peak effect on TOFR of neostigmine 35 lg.kg TOF ratio Figure 2 Recovery of train-of-four ratio (TOF ratio) after the administration of neostigmine 40 lg.kg )1 and atropine 20 lg.kg )1 in the Diabetic group (d) and Control group (s). Error bars indicate SD.…”

Section: R E T R a C T E Dmentioning

confidence: 99%

“…For this reason, recovery from neuromuscular blockade was studied for 15 min after neostigmine administration in this study. It has been recommended that an anticholinesterase should only be given when T1 ⁄ control has returned to 0.25 [17,[25][26][27]. Furthermore, it has been shown that when an anticholinesterase is administered at a T1 ⁄ control of 0.25, TOFR may only barely return to a value of 0.9 [14][15][16][17].…”

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confidence: 99%

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Retracted: Reversal of vecuronium with neostigmine in patients with diabetes mellitus

Saitoh

Hattori²,

Sanbe³

et al. 2004

Anaesthesia

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SummaryReversal of vecuronium-induced neuromuscular blockade with neostigmine was compared in two groups of 16 subjects: patients with Type 2 diabetes mellitus and normal controls. When the first twitch of the train-of-four had returned to 25% of the control value, neostigmine 40 lg.kg )1 and atropine 20 lg.kg )1 were given to reverse the neuromuscular blockade. The train-of-four ratio was lower at 3 min, 6 min, 9 min, 12 min and 15 min after reversal in the diabetic group than in the control group but the differences did not reach statistical significance. Fifteen minutes after reversal, the number of patients in whom recovery from neuromuscular blockade was judged insufficient to guarantee good respiratory function (train-of-four ratio < 0.74) did not differ between the groups. However, 15 min after reversal, the number of patients with a train-of-four ratio < 0.9 was significantly higher in the Diabetic Group than in the Control Group (15 vs. 10, p = 0.033).

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Section: R E T R a C T E Dmentioning

confidence: 99%

mentioning

confidence: 99%

Retracted: Reversal of vecuronium with neostigmine in patients with diabetes mellitus

Saitoh

Hattori²,

Sanbe³

et al. 2004

Anaesthesia

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“…6 Even in these circumstances, it takes up to 10 min to achieve the full effect of anticholinesterases. 7 In comparison, sugammadex, a modified gamma cyclodextrin, is a selective relaxant binding agent specifically designed to encapsulate rocuronium, 8 which can, therefore, promptly restore neuromuscular function regardless of any levels of neuromuscular block as the dose is increased. 9 -11 If the marked reductions in recovery time are replicated in routine clinical practice, sugammadex contributes to save time and has the potential to be cost-effective compared with neostigmine.…”

mentioning

confidence: 99%

Reversibility of rocuronium-induced profound neuromuscular block with sugammadex in younger and older patients

Suzuki

Kitajima

Ueda

et al. 2011

British Journal of Anaesthesia

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“…In fact, very recent data documented that qualitative (subjective) assessment of TOF monitoring performed at the eye muscles resulted in a fivefold increase in the risk of postoperative residual block compared with assessment at the adductor pollicis muscle [23]. Second, if satisfactory neuromuscular recovery (a TOF ratio C 0.90) is to be achieved at the time of tracheal extubation, neostigmine administration should precede this maneuver by not less than 10 min, since the drug's peak effect may not manifest itself until approximately this interval has elapsed [55].…”

Section: The Efficacy and Limitations Of Neostigmine As A Reversal Agmentioning

confidence: 99%

Management Principles to Reduce the Risk of Residual Neuromuscular Blockade

Brull

Kopman

Naguib

2013

Curr Anesthesiol Rep

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The perioperative use of neuromuscular blocking agents has revolutionized medicine, and has allowed numerous and significant advances in the surgical management of patients. However, surgical advancement has not been devoid of attendant complications such as intraoperative patient recall, residual neuromuscular weakness, pulmonary aspiration of gastric contents, and need for tracheal reintubation. This chapter briefly reviews the various ways in which clinicians can optimize the timing and dosing of muscle relaxants, improve perioperative monitoring of muscle relaxation, and enhance the pharmacologic reversal of neuromuscular block. These strategies are intended to reduce the incidence of postoperative neuromuscular weakness and improve the safety of patients undergoing surgery and general anesthesia.

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Time to peak effect of neostigmine at antagonism of atracurium- or vecuronium-induced neuromuscular block

Cited by 22 publications

References 27 publications

Retracted: Reversal of vecuronium with neostigmine in patients with diabetes mellitus

Retracted: Reversal of vecuronium with neostigmine in patients with diabetes mellitus

Reversibility of rocuronium-induced profound neuromuscular block with sugammadex in younger and older patients

Management Principles to Reduce the Risk of Residual Neuromuscular Blockade

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