Neostigmine failed to modify the development of neuromuscular block in the presence of a high local concentration of tubocurarine. Only when the concentration of tubocurarine was reduced, and a suitable concentration gradient established between the receptor area and the plasma, did neostigmine increase the rate of recovery from the action of non-depolarizing neuromuscular blocking agents.

This systematic review describes the evidence on the use of acceleromyography for perioperative neuromuscular monitoring in clinical practice and research. The review documents that although acceleromyography is widely used in research, it cannot be used interchangeably with mechanomyography and electromyography for construction of dose-response curves or for recording different pharmacodynamic...

Correspondence: Sorin J Brull Department of Anesthesiology, Mayo Clinic College of Medicine, 4500 San Pablo road, Jacksonville, FL 32224, USA Tel +1 904 956 3331 Fax +1 904 956 3332 email [email protected] Abstract: Despite the significant improvements in the pharmacology of muscle relaxants in the past six decades, the search for the ideal muscle relaxant continues, mainly because of the inc...

We have investigated the effects of adenosine i.v. on neuromuscular block induced by rocuronium, vecuronium and pipecuronium in an in vivo guinea-pig sciatic nerve-tibialis anterior preparation. The ED50 of each neuromuscular blocker was determined from cumulative log dose-response regression lines (n = 14). In separate experiments, adenosine 0.1 mg kg-1 min-1 or the same volume of 0.9% NaCl wa...

Anaesthesiologists must be prepared to deal with pharmacokinetic and pharmacodynamic (PD) differences in morbidly obese individuals. As drug administration based on total body weight can result in overdose, weight-based dosing scalars must be considered. Conversely, administration of drugs based on ideal body weight can result in a sub-therapeutic dose. Changes in cardiac output and alterations...

OBJECTIVES Treatment of mitochondrial disorders (MIDs) is a challenge, since there is no causal therapy available and since there are few studies available, which demonstrate an effect of any agents offered for symptomatic or supportive therapy. Treatment of MIDs is based on five main columns, including symptomatic measures, application of supportive agents, dietary measures, physiotherapy, and...

Neuromuscular disorders like myotonic dystrophy (dystrophia myotonica or Steinert's disease) and spinal muscular atrophy are associated with perioperative complications related to muscle weakness. These patients have an increased sensitivity to non-depolarising neuromuscular blocking agents, which can lead to postoperative residual curarization (PORC) and its associated respiratory complication...

INTRODUCTION Neostigmine is a frequently used acetylcholinesterase inhibitor administered to reverse muscular relaxation caused by nondepolarizing neuromuscular relaxants in patients recovering from general anesthesia. Severe allergic reactions and urticaria are rarely reported following the use of neostigmine bromide, and never with methylsulfate-containing drugs. In this case, bigeminal prema...