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Korean Journal of Anesthesiology 1996;30(5):604-609.
DOI: https://doi.org/10.4097/kjae.1996.30.5.604   
The Divided Doses of Neostigmine for the Rapid Recovery at Profound Muscle Relaxation of Pancuronium in Rabbits.
Kyo Sang Kim, Do Jun Na, Jong Hun Jun, Woo Jong Shin
Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea.
The reversal of neuromuscular blocker might be accelerated if the anticholinesterase was administered in divided doses. This study has been conducted to evaluate the correct ratio of divided doses of neostigmine for the rapid recovery in the rabbits after pancuronium when the profound relaxation(PTC=0) was confirmed.
Rabbits(n=60) were randomly allocated to 6 groups. After pancuronium 0.2 mg/kg intravenously, spontaneous recovery was evaluated in group 1. When the profound relaxation(PTC=O) was confirmed at 5 min. after pancuronium, neostigmine 50 ug/kg was injected as a bolus in group 2. At that time, neostigmine was given at 10 ug/kg followed by 40 ug/kg 3 min. later in group 3. At that time, neostigmine was given at 20 ug/kg followed by 30 ug/kg 3 min. later in group 4. At that time, neostigmine was given at 30 ug/kg followed by 20 ug/kg 3 min. later in group 5. At that time, neostigmine was given at 40 ug/kg followed by 10 ug/kg 3 min. later in group 6.
The mean time from injection of pancuronium to 95% recovery was 99.3 min. in group 1, 59.8 min. in group 2, 53.2 min. in group 3, 51.5 min. in group 4, 50.8 min. in group 5 and 41.1 min. in group 6. The recovery index was significantly reduced in group 6(p<0.05).
We conclude that the recovery time is reduced when neostigmine is administered in divided doses: a larger priming dose followed by a smaller bolus at profound relaxation.
Key Words: Antagonist; neuromuscular relaxants; neostigmine; Phamacology; ratio of divided doses; pancuronium; Pharmacokinetics; recovery


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