Key result
Neostigmine administered 1 to 4 hours after vecuronium increased the TOF ratio in 52 of 60 patients, but decreased it in 8 patients and caused adverse cardiovascular effects in 50%.
Why the study?
Does neostigmine effectively reverse residual neuromuscular block at 1 to 4 hours after a single dose of vecuronium?
Population
60 patients during nitrous oxide/isoflurane/fentanyl anesthesia who received a single intubating dose of…
Design
Other
Follow-up
up to 4 hours
Authors
Loading...
Neostigmine may paradoxically worsen block or cause cardiovascular effects; leaves open optimal reversal timing after vecuronium.
Does neostigmine effectively reverse residual neuromuscular block at 1 to 4 hours after a single dose of vecuronium?
Neostigmine can effectively reverse residual neuromuscular block from vecuronium up to 4 hours later, but may paradoxically decrease TOF ratios if given when recovery is already near complete, and carries a high risk of cardiovascular adverse effects.
James E. Caldwell (1995) studied Patients undergoing anesthesia (n=60). Neostigmine was evaluated on Train-of-four (TOF) ratio. Neostigmine administered 1 to 4 hours after vecuronium increased the TOF ratio in 52 of 60 patients, but decreased it in 8 patients and caused adverse cardiovascular effects in 50%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: