Does discontinuation of desflurane at the time of neostigmine administration speed recovery from cisatracurium block compared to that with a propofol-based technique?

Acta Anaesthesiologica Scandinavica
H Kirkegaard-NielsenTom Heier

Abstract

Volatile anaesthetics are known to influence the effect of neostigmine as an antagonist of neuromuscular block. The aim of the present study was to investigate whether discontinuation of desflurane at the time of neostigmine administration shortens reversal time from cisatracurium block, compared to that with a propofol-based anaesthesia. Ten volunteers were studied twice. For one study, anaesthesia was induced with alfentanil and propofol and maintained with nitrous oxide 70% and propofol 150 microg. kg-1. min-1. For the other study, experimental conditions were replicated except that desflurane 6% was administered and the dose of propofol was only 50 microg. kg-1. min-1. The evoked mechanical response of the adductor pollicis to train-of-four (TOF) stimulation was recorded. Neuromuscular block was induced with cisatracurium 0.2 mg. kg-1. When the magnitude of the first TOF response (T1) had recovered to 10%, the block was antagonized with neostigmine 70 microg. kg-1. At this time, propofol was decreased to 50 microg. kg-1. min-1, or the desflurane was discontinued. There were no significant differences between the two techniques of anaesthesia in the rate of neostigmine-induced recovery of the TOF ratio. The times (mean+/-SD)...Continue Reading

References

Oct 1, 1992·Anesthesiology·D R BevanA F Kopman
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Citations

Mar 11, 2009·Journal of Critical Care·James E Caldwell

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