I.M. Bali

Reversal of neuromuscular block

The effect on heart rate of different rates of injection (10 seconds, 1, 3 und 5 minutes) of a fixed dose (neostigmine 2.5 mg and atropine 1.2 mg) and a weight‐related dose (neostigmine 50 μg/kg and atropine 25 μg/kg) of neostigmine‐atropine mixture given for the reversal of residual competitive neuromuscular block was studied in 196 healthy adult patients. In both series slow injection lessened and delayed the initial rise in heart rate. The subsequent fall in heart rate was less when the drugs were injected over 3 min compared with the 10 seconds and 1 minute injection groups but when given over 5 minutes there was a steady fall in heart rate, more so with the weight‐related dose. It is recommended that a neostigmine and atropine mixture should be administered over 3 min.

Reversal of neuromuscular block. Heart rate changes with slow injection of neostigmine and atropine mixtures.

The effect on heart rate of different rates of injection (10 seconds, 1, 3 and 5 minutes) of a fixed dose (neostigmine 2.5 mg and atropine 1.2 mg) and a weight-related dose (neostigmine 50 micrograms/kg and atropine 25 micrograms/kg) of neostigmine-atropine mixture given for the reversal of residual competitive neuromuscular block was studied in 196 healthy adult patients. In both series slow injection lessened and delayed the initial rise in heart rate. The subsequent fall in heart rate was less when the drugs were injected over 3 min compared with the 10 seconds and 1 minute injection groups but when given over 5 minutes there was a steady fall in heart rate, more so with the weight-related dose. It is recommended that a neostigmine and atropine mixture should be administered over 3 min.

Clinical Evaluation of Org NC 45

Org NC 45, a new non-depolarizing neuromuscular blocking drug, was evaluated in 200 adult patients. The drug was administered in doses of 0.1, 0.15 or 0.2 mg kg-1. Intubation could be satisfactorily carried out at around 90 s in 90% of patients. The duration of clinical relaxation varied from 23 min with 0.1 mg kg-1 and neuroleptanaesthesia to 71 min with 0.2 mg kg-1 and anaesthesia with halothane or enflurane. The duration of clinical relaxation following repeated administration of 2-3 mg was remarkably constant (between 17 and 20 min) thus showing lack of cumulation. The antagonism of residual block was prompt and easy following administration of neostigmine, and the drug lacked any significant cardiovascular effects as seen by routine monitoring.