Comparative study on reversal of neuromuscular blockade induced by D-tubocurarine, pancuronium, gallamine and atracurium using neostigmine

ABSTRACT

A sample of 120 patients of both sexes of class 1 ASA classification scheduled for elective surgery were divided into four equal groups, each of 30 patients according to the neuromuscular [NM] blocker used either tubocurarine, pancuronium, gallamine or atracurium, respectively. After the initial dose of muscle relaxant the incremental doses of muscle relaxant and the dose of neostigmine were given to patients judged by nerve stimulator. It was found that the more the duration of the operation, the more the need to muscle relaxant and the more neostigmine requirement for reversal. The degree of NM blockade at which reversal can be initiated is a far more important than the total dose of relaxant administered. Neostigmine 2.5 mg was the maximum dose for reversal of severe degree of neuromuscular block. Atracurium at lesser degrees of block required less neostigmine than other muscle relaxants