Antagonism of ketamine by 4-aminopyridine and physostigmine.

Saemund and Dalcnius reported five cases of nodal rhythm directly related to the injection of pancuronium 0.1 mgkg" •. We, too, have witnessed several examples of transient nodal rhythm after the administration of pancuronium and not infrequently this rhythm disturbance has been accompanied by a decrease in arterial pressure. Recent reviews (PrysRoberts, 1981) emphasize the potential deleterious effects of this rhythm disturbance in patients suffering from hypertension and coronary artery heart disease and we have demonstrated severe deterioration of circulation during an episode of nodal rhythm even in an apparently healthy patient (Heinonen, Salmenpera and Takkunen, 1981a) Although atnoventncular dissociation has been observed in a considerable proportion of cases during the onset of alcuroruum block also (Haldcmann and Schaer, 1972), a re-evaluation of the frequency of nodal rhythm in association with various neuromuscular blocking drugs may be indicated