Donati F, Bevan D R
Anesth Analg. 1985 Aug;64(8):773-6.
The neuromuscular effect of neostigmine, 1.25 mg/70 kg, was assessed in 40 adult patients 10 min after cessation of a succinylcholine infusion. The patients had received a thiopental-nitrous oxide anesthetic supplemented by halothane or fentanyl during which they were given at least 5 mg/kg succinylcholine over more than 90 min. Train-of-four monitoring was used. Neostigmine accelerated recovery of neuromuscular function in all patients. The degree of recovery was directly related to the train-of-four ratio, and the results in patients who had received halothane were no different from those who had received fentanyl. The findings are compatible with the hypothesis that phase I block depends upon the presence of circulating succinylcholine and decreases as the latter is cleared, whereas phase II block decreases more slowly. Thus succinylcholine block can be antagonized by neostigmine if enough time is allowed for phase I block to disappear and for a pure phase II block to be present.
在40例成年患者停止输注琥珀酰胆碱10分钟后，评估了1.25毫克/70千克新斯的明的神经肌肉效应。这些患者接受了硫喷妥钠-氧化亚氮麻醉，并辅以氟烷或芬太尼，在此期间，他们在90多分钟内至少接受了5毫克/千克的琥珀酰胆碱。采用四个成串刺激监测。新斯的明加速了所有患者神经肌肉功能的恢复。恢复程度与四个成串刺激比率直接相关，接受氟烷的患者结果与接受芬太尼的患者无异。这些发现与以下假设相符：I期阻滞取决于循环中琥珀酰胆碱的存在，并随着后者的清除而降低，而II期阻滞下降得更慢。因此，如果有足够的时间让I期阻滞消失并出现单纯的II期阻滞，新斯的明可以拮抗琥珀酰胆碱阻滞。
