The Early Reversibility of Rocuronium After Different Doses of Neostigmine
The Early Reversibility of Rocuronium After Different Doses of Neostigmine
Neuromuscular blocking agents are commonly used to facilitate endotracheal intubation.
 Succinylcholine, an ultra short-acting, depolarizing neuromuscular blocking agent, is the
 most commonly used agent for paralysis in this setting because of its rapid onset and short
 duration of paralysis. In patients with contraindications to succinylcholine or in whom a
 difficult airway is anticipated, a neuromuscular blocking agent with a pharmacodynamic
 profile similar to succinylcholine would be an attractive alternative. Rocuronium, a new
 intermediate-acting nondepolarizing neuromuscular blocking agent produces paralysis within 60
 seconds, similar to succinylcholine, but has a duration of paralysis of approximately 20 to
 30 minutes. If rocuronium-induced paralysis could be chemically reversed within 10 to 15
 minutes after the administration of an intubating dose, it may be an appropriate alternative
 in patients with contraindications to succinylcholine or in patients whom a difficult airway
 is anticipated. Neostigmine is an anticholinesterase agent which inhibits the hydrolysis of
 acetylcholine by competing with acetylcholine for attachment to acetylcholinesterase.
 Inhibition of the breakdown of acetylcholine allows the neurotransmitter to be present in the
 neuromuscular junction for a longer period of time, so that each molecule can bind repeatedly
 with the acetylcholine receptor. The purpose of this study is to determine the dose of
 neostigmine necessary for the early reversal of rocuronium-induced paralysis.
Neuromuscular blocking agents are commonly used to facilitate endotracheal intubation.
 Succinylcholine, an ultra short-acting, depolarizing neuromuscular blocking agent, is the
 most commonly used agent for paralysis in this setting because of its rapid onset and short
 duration of paralysis. In patients with contraindications to succinylcholine or in whom a
 difficult airway is anticipated, a neuromuscular blocking agent with a pharmacodynamic
 profile similar to succinylcholine would be an attractive alternative. Rocuronium, a new
 intermediate-acting nondepolarizing neuromuscular blocking agent produces paralysis within 60
 seconds, similar to succinylcholine, but has a duration of paralysis of approximately 20 to
 30 minutes. If rocuronium-induced paralysis could be chemically reversed within 10 to 15
 minutes after the administration of an intubating dose, it may be an appropriate alternative
 in patients with contraindications to succinylcholine or in patients whom a difficult airway
 is anticipated. Neostigmine is an anticholinesterase agent which inhibits the hydrolysis of
 acetylcholine by competing with acetylcholine for attachment to acetylcholinesterase.
 Inhibition of the breakdown of acetylcholine allows the neurotransmitter to be present in the
 neuromuscular junction for a longer period of time, so that each molecule can bind repeatedly
 with the acetylcholine receptor. The purpose of this study is to determine the dose of
 neostigmine necessary for the early reversal of rocuronium-induced paralysis.
American Society of Anethesiology Class I-III adult patients undergoing elective surgery
 requiring neuromuscular blockage for endotracheal intubation.

 No pre-existing renal or hepatic disease, Myasthenia-Gravis, Eaton-Lambert Disease,
 pregnancy, concurrent anticonvulsant therapy, history of hypersensitivity to rocuronium,
 neostigmine, or glycopyrrolate.