The Effect of Neostigmine on the Train-of-four Ratio during the Recovery from Vecuronium- or Atracurium-induced Neuromuscular Blockade / 대한마취과학회지

ABSTRACT

BACKGROUND: The train-of-four(TOF) fade known as expression of prejuntional receptor binding was useful for evaluating the residual neuromuscular blockade(NMB). The present study was undertaken to investigate the effect of the neostigmine(Neo) on TOF ratio during the recovery from vecuronium(V) or atracurium(A) induced NMB under the general anesthesia. METHODS: Forty healthy adult patients were randomly divided into 4 groups as follows; spontaneous recovery from V-induced NMB(V-C group) or A-induced NMB(A-C group), reversed recovery with Neo at 20% recovery of control first twitch height(T) from V-induced NMB(V-R group) or A-induced NMB(A-R group). TOF ratio at 25 and 75% recovery of T and recovery index(RI) defined as time from 25 to 75% recovery of T were measured. RESULTS: TOF ratios at 25 and 75% recovery of T were 3.7 & 35.8%(V-C group), 8.4 & 46.9%(A-C group), 3.7 & 48.7%(V-R group) and 15.2 & 55.6%(A-R group) respectively(P>0.05). RI were 19.2 min(V-C group), 19.5 min(A-C group), 3.5 min(V-R group), and 5.6 min(A-R group) respectively (P<0.05). CONCLUSIONS: RI were significantly shortened in reversed recovery groups with Neo than spontaneous recovery groups (P<0.05). However TOF ratio at 75% recovery of T1 were not significantly different between spontaneous recovery and reversed recovery groups.