TY - JOUR
T1 - Impaired neostigmine antagonism of pancuronium during enflurane anaesthesia in man
AU - Delisle, S.
AU - Bevan, D. R.
PY - 1982/4
Y1 - 1982/4
N2 - We have compared the rates of recovery of pancuronium-induced neuromuscular blockade after administration of neostigmine during anaesthesia maintained with nitrous oxide and intermittent narcotics, halothane or enflurane. Thirty patients were studied m whom anaesthesia was maintained with 70% nitrous oxide in oxygen with: fentanyl or thiopentone, halothane (0.55-0.65% end-tidal), or enflurane (1.3-1.4% end-tidal). Muscle twitch response was measured using train-of-four stimulation. Pancuronium 3mg/70kg was antagonized with neostigmine 2.5mg/70kg at 10% spontaneous recovery of the first twitch of the train compared with control. There were no significant differences between the times to 10% spontaneous recovery of the first twitch or the rates of train-of-four recovery after neostigmine when the narcotic and halothane groups were compared. However, enflurane anaesthesia, m comparison with fentanyl, was associated with a significant increase in the time to 10% recovery (57.9 ±6.0 min v. 35.4 ±7 0 min) and with decreases in the train-of-four recoveries at 4, 5, 10, 20 and 30 min after neostigmine. We conclude that, under the conditions of this study, the antagonism of pancuronium-induced neuromuscular blockade with neostigmine was impaired during enflurane but not halothane anaesthesia.
AB - We have compared the rates of recovery of pancuronium-induced neuromuscular blockade after administration of neostigmine during anaesthesia maintained with nitrous oxide and intermittent narcotics, halothane or enflurane. Thirty patients were studied m whom anaesthesia was maintained with 70% nitrous oxide in oxygen with: fentanyl or thiopentone, halothane (0.55-0.65% end-tidal), or enflurane (1.3-1.4% end-tidal). Muscle twitch response was measured using train-of-four stimulation. Pancuronium 3mg/70kg was antagonized with neostigmine 2.5mg/70kg at 10% spontaneous recovery of the first twitch of the train compared with control. There were no significant differences between the times to 10% spontaneous recovery of the first twitch or the rates of train-of-four recovery after neostigmine when the narcotic and halothane groups were compared. However, enflurane anaesthesia, m comparison with fentanyl, was associated with a significant increase in the time to 10% recovery (57.9 ±6.0 min v. 35.4 ±7 0 min) and with decreases in the train-of-four recoveries at 4, 5, 10, 20 and 30 min after neostigmine. We conclude that, under the conditions of this study, the antagonism of pancuronium-induced neuromuscular blockade with neostigmine was impaired during enflurane but not halothane anaesthesia.
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U2 - 10.1093/bja/54.4.441
DO - 10.1093/bja/54.4.441
M3 - Article
C2 - 7066141
AN - SCOPUS:0020068661
SN - 0007-0912
VL - 54
SP - 441
EP - 445
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 4
ER -