Reversal of pipecuronium bromide with pyridostigmine

Pipecuronium Bromide (Arduan, Organon, Inc, West Orange) is a long-acting, nondepolarizing neuromuscular blocking agent. The efficacy of pyridostigmine 170 micrograms/kg intravenously (approximately 10 mg/70 kg) for reversing pipecuronium has not been reported. This study was performed to determine...

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Bibliographic Details
Published in:	CRNA (Philadelphia, Pa.) Vol. 6; no. 1; p. 43
Main Authors:	Alisoglu, R M, Nagelhout, J, Kyff, J V, Perov, S, Santoro, P W, Scarsella, J
Format:	Journal Article
Language:	English
Published:	United States 01-02-1995
Subjects:	Adult Electric Stimulation Electromyography Female Humans Male Monitoring, Intraoperative Nerve Block - methods Neural Conduction Pipecuronium - therapeutic use Pyridostigmine Bromide - therapeutic use Time Factors
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Summary:	Pipecuronium Bromide (Arduan, Organon, Inc, West Orange) is a long-acting, nondepolarizing neuromuscular blocking agent. The efficacy of pyridostigmine 170 micrograms/kg intravenously (approximately 10 mg/70 kg) for reversing pipecuronium has not been reported. This study was performed to determine the time required to obtain a train-of-four (TOF) ratio of 0.7 after administration of pyridostigmine 140 micrograms/kg at 25% recovery of T1 after pipecuronium-induced neuromuscular blockade. Sixteen, American Society of Anesthesiology (ASA) I or II patients undergoing surgical procedures of at least 90 minutes, requiring intubation and muscle relaxation were included. Neuromuscular blockade was assessed using the Puritan-Bennett/Datex NMT 221 placed for ulnar nerve stimulation. Anesthesia was maintained with a nitrous oxide/narcotic technique and the use of potent inhalational anesthetics was avoided. The mean reversal time was found to be 16.14 minutes, with a minimum of 10.3 minutes and a maximum of 24.3 minutes. The standard error was +/- 1.05 minutes with a variance of 17.68 minutes.
ISSN:	1048-2687