Key result
Repeated doses of neostigmine induced a longstanding coronary artery vasospasm lasting several hours, resulting in myocardial damage and left ventricular dysfunction.
Why the study?
Does neostigmine administration cause coronary artery spasm?
Case Report (n=1)
Does neostigmine administration cause coronary artery spasm?
Neostigmine administration can rarely induce severe, prolonged coronary artery spasm leading to myocardial damage and left ventricular dysfunction.
May warrant caution with repeated neostigmine dosing; single case leaves open causality and generalizability.
Neostigmine is a cholinesterase inhibitor which does not cross the blood brain barrier and a commonly used for reversal of nondepolarizing muscle relaxants. In the following case report, we present a patient who developed coronary artery spasm, after the administration of repeated doses of neostigmine. Ours is the first case to demonstrate such a longstanding coronary artery vasospasm that lasted several hours in response to neostigmine, resulting in myocardial damage and left ventricular dysfunction. We would like to draw the attention of the anesthesiologists to this rare effect that may lead to perioperative cardiac complications.
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Ioscovich et al. (2017) conducted a case report in Corary artery spasm (n=1). Neostigmine was evaluated on Coronary artery spasm resulting in myocardial damage and left ventricular dysfunction. Repeated doses of neostigmine induced a longstanding coronary artery vasospasm lasting several hours, resulting in myocardial damage and left ventricular dysfunction.
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