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Anesth Analg 1983; 62:314-316
© 1983 International Anesthesia Research Society
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Twitch Depression and Train-of–Four Ratio after Antagonism of Pancuronium with Edrophonium, Neostigmine, or Pyridostigmine

François Donati, MD, PhD, Ann Ferguson, MB, FFARCS, and David R. Be van, MB, FFARCS

Department of Anaesthesia, Royal Victoria Hospital, and McGill University, Montreal, Quebec, Canada.

Abstract

During N2O--O2--halothane anesthesia pancuronium (3 mg/70 kg) was antagonized with neostigmine (2.5 or 5 mg/70 kg), pyridostigmine (10 or 20 mg/70 kg), or edrophonium (50 or 100 mg/70 kg) in 36 human subjects (6 in each group). Reversal was attempted at 10% spontaneous recovery of muscle twitch, which was measured using train-of-four stimulation. When first twitch tension was less than 70% of the control it was found that for the same tension, the train-of-four ratio was greater with edrophonium than with neostigmine, and greater with neostigmine than with pyridostigmine. It was concluded that the three antagonists have different mechanisms of action. In comparison with neostigmine, edrophonium is more and pyridostigmine is less effective at presynaptic (or fade) receptors.

Key Words: ANTAGONISTS, Neuromuscular Relaxants: edrophonium, neostigmine, pyridostigmine • NEUROMUSCULAR RELAXANTS: measurement of response • NEUROMUSCULAR TRANSMISSION: train-of-four






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1983 by the International Anesthesia Research Society.