Antagonism of neuromuscular blockade but not muscle relaxation affects depth of anaesthesia
Details
State: Public
Version: Final published version
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_5B05B1AC5000
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Antagonism of neuromuscular blockade but not muscle relaxation affects depth of anaesthesia
Journal
British Journal of Anaesthesia
ISSN
0007-0912 (Print)
Publication state
Published
Issued date
06/2005
Volume
94
Number
6
Pages
742-7
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial --- Old month value: Jun
Journal Article
Randomized Controlled Trial --- Old month value: Jun
Abstract
BACKGROUND: Conflicting effects of neuromuscular blocking drugs and anticholinesterases on depth of anaesthesia have been reported. Therefore we evaluated the effect of atracurium and neostigmine on bispectral index (BIS) and middle-latency auditory evoked potentials (AAI). METHODS: We studied 40 patients (ASA I-II) aged 18-69 yr. General anaesthesia consisted of propofol and remifentanil by target-controlled infusion and neuromuscular function was monitored by electromyography. When BIS reached stable values, patients were randomly assigned to one of two groups. Group 1 received atracurium 0.4 mg kg(-1) and, 5 min later, the same volume of NaCl 0.9%; group 2 received saline first and then atracurium. When the first twitch of a train of four reached 10% of control intensity, patients were again randomized: one group (N) received neostigmine 0.04 mg kg(-1) and glycopyrrolate 0.01 mg kg(-1), and the control group (G) received only glycopyrrolate. RESULTS: Injection of atracurium or NaCl 0.9% had no effect on BIS or AAI. After neostigmine-glycopyrrolate, BIS and AAI increased significantly (mean maximal change of BIS 7.1 [SD 7.5], P<0.001; mean maximal change of AAI 9.7 [10.5], P<0.001). When glycopyrrolate was injected alone BIS and AAI also increased (mean maximal change of BIS 2.2 [3.4], P=0.008; mean maximal change of AAI 3.5 [5.7], P=0.012), but this increase was significantly less than in group N (P=0.012 for BIS; P=0.027 for AAI). CONCLUSION: These data suggest that neostigmine alters the state of propofol-remifentanil anaesthesia and may enhance recovery.
Keywords
Adult
Aged
Anesthetics, Combined/pharmacology
Anesthetics, Intravenous/*pharmacology
Atracurium/pharmacology
Blood Pressure/drug effects
Cholinesterase Inhibitors/*pharmacology
Double-Blind Method
Drug Interactions
Electroencephalography/drug effects
Evoked Potentials, Auditory/*drug effects
Female
Heart Rate/drug effects
Humans
Male
Middle Aged
Monitoring, Intraoperative/methods
Muscle Relaxation/*drug effects
Neostigmine/pharmacology
*Neuromuscular Blockade
Neuromuscular Nondepolarizing Agents/pharmacology
Piperidines/pharmacology
Propofol/pharmacology
Prospective Studies
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 11:52
Last modification date
14/02/2022 8:55