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Anesth Analg 1985; 64:773-776
© 1985 International Anesthesia Research Society
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Antagonism of Phase II Succinylcholine Block by Neostigmine

Francois Donati, PHD, MD, FRCP(C), and David R. Bevan, MB, MRCP, FFARCS

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

Abstract

The neuromuscular effect of neostigmine, 1.25 mg/70 kg, was assessed in 40 adult patients 10 min after cessation of a succinylcholine infusion. The patients had received a thiopental-nitrous oxide anesthetic supplemented by halothane or fentanyl during which they were given at least 5 mg/kg succinylcholine over more than 90 min. Train-of-four monitoring was used. Neostigmine accelerated recovery of neuromuscular function in all patients. The degree of recovery was directly related to the train-of-four ratio, and the results in patients who had received halothane were no different from those who had received fentanyl. The findings are compatible with the hypothesis that phase I block depends upon the presence of circulating succinylcholine and decreases as the latter is cleared, whereas phase II block decreases more slowly. Thus succinylcholine block can be antagonized by neostigmine if enough time is allowed for phase I block to disappear and for a pure phase II block to be present

Key Words: ANTAGONISTS—neostigmine. NEUROMUSCULAR RELAXANTS—succinylcholine.






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 © 1985 by the International Anesthesia Research Society.