BACKGROUND: Reversal of neuromuscular blockade induced with pancuronium, d-tubocurarine, or doxacurium is achieved using smaller doses of neostigmine in adults than in children. Also, pancuronium- and doxacurium-induced blockade is reversed with smaller doses of edrophonium in children than in adults. The purpose of this study was to compare the spontaneous and neostigmine- and edrophonium-assisted recovery of mivacurium-induced neuromuscular block in adults and children., METHODS: Fifty-four adults, aged 40.1 +/- 10.9 yr, and 54 children, aged 4.9 +/- 0.7 yr, physical status ASA 1-2, were studied during propofol/fentanyl/nitrous oxide anesthesia. A Datex relaxograph was used to monitor the electromyographic response of the adductor pollicis to train-of-four stimulation of the ulnar nerve every 10 s. After induction of anesthesia, 0.2 mg x kg(-1) intravenous mivacurium was administered followed by an infusion to maintain 90-95{%} T1 block. At the end of surgery, one of four doses of neostigmine (5, 10, 20, and 50 micrograms x kg(-1)) or edrophonium (100, 200, 400, and 1,000 micrograms x kg(-1)) or placebo was given, by random allocation, when T1 had recovered to 10{%}. Values of T1 and train-of-four were measured for 10 min., RESULTS: Spontaneous recovery proceeded more rapidly in children than in adults. At 10 min, T1 had recovered to 97 +/- 2{%} (SD) in children compared with 69 +/- 11{%} in adults and train-of-four to 84 +/- 5{%} versus 30 +/- 13{%} (P{
CITATION STYLE
BEVAN, J. C., TOUSIGNANT, C., STEPHENSON, C., BLACKMAN, L., REIMER, E., SMITH, M. F., & BEVAN, D. R. (1997). Dose Responses for Neostigmine and Edrophonium as Antagonists of Mivacurium in Adults and Children. Survey of Anesthesiology, XLI(2), 113. https://doi.org/10.1097/00132586-199704000-00045
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