[Neuromuscular blockade after a chain of two laparotomies in a few hours].

A 59-year-old man with chronic renal failure underwent the ascending colectomy. After administration of neostigmine 2 mg, his postoperative neuromuscular recovery was good. The second laparotomy was undertaken one hour after extubation because gauze was left in his abdomen. Fifty minutes after intubation using rocuronium 40 mg (0.6 mg x kg(-1)), neostigmine 4 mg (0.06 mg x kg(-1)) was administrated. But we failed to reverse neuromuscular blockade and the patient fell into respiratory depression. After a chain of two operations, the administration of neostigmine in second operation requires circumspection when the effect of neostigmine administrated in the first operation is continuing, because the proper evaluation of residual neuromuscular blockade is difficult.