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Antagonism of pancuronium- and pipecuronium-induced neuromuscular block.
Gyermek, L; Cantley, E M; Lee, C.
Affiliation
  • Gyermek L; Department of Anesthesiology, Harbor-UCLA Medical Center, Torrance 90222, USA.
Br J Anaesth ; 74(4): 410-4, 1995 Apr.
Article in En | MEDLINE | ID: mdl-7734260
We have compared the antagonism of neuromuscular block produced by pipecuronium with pancuronium in 80 anaesthetized surgical patients using mechanomyography and electromyography. Pancuronium 0.1 mg kg-1 or pipecuronium 0.07 mg kg-1 was given after induction of anaesthesia and neuromuscular block was adjusted to 75% twitch depression at the time of antagonism. The following regimens were used: edrophonium 0.5 and 1.0 mg kg-1, neostigmine 0.04 mg kg-1, pyridostigmine 0.3 mg kg-1 and edrophonium 0.25 mg kg-1 with pyridostigmine 0.15 mg kg-1. Antagonism was evaluated also by the head lift test. There was no difference between the reversibility of neuromuscular block produced by pancuronium or pipecuronium. Edrophonium produced a significantly faster antagonism than neostigmine or pyridostigmine but onset of action was not significantly faster than that of edrophonium with pyridostigmine. All regimens produced 100% (or near 100%) antagonism of twitch response within 15 min. However, TOF fade antagonism was more complete with pyridostigmine, neostigmine and edrophonium 1.0 mg kg-1 than with edrophonium 0.5 mg kg-1. The head lift test indicated somewhat less antagonism with edrophonium 0.5 and 1.0 mg kg-1. Using five monitoring methods, the rank order of reversal potency was: pyridostigmine approximately neostigmine > edrophonium 1.0 mg kg-1 > edrophonium+pyridostigmine > edrophonium 0.5 mg kg-1.
Subject(s)
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Database: MEDLINE Main subject: Pancuronium / Pipecuronium / Nerve Block Type of study: Clinical_trials Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Br J Anaesth Year: 1995 Type: Article
Search on Google
Database: MEDLINE Main subject: Pancuronium / Pipecuronium / Nerve Block Type of study: Clinical_trials Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Br J Anaesth Year: 1995 Type: Article