Patients undergoing surgery often receive paralytic agents (or neuromuscular blocking agents
(NMBAs)) to facilitate the procedure. At the end of surgery, the effects NMBAs are reversed
with a drug called neostigmine. The use of neostigmine significantly reduces the risk that a
patient will be left with muscle weakness in the recovery room. Many anesthesiologists
routinely use neostigmine because postoperative muscle weakness may lead to adverse events
after surgery. Other anesthesiologists do not routinely administer neostigmine in the
operating room because of concerns about potential side effects. Surprisingly, some
investigators have reported that neostigmine-induced muscle weakness may occur if the drug is
given when the effects of the NMBAs have completely worn off. In contrast, other
investigators have not observed this side effect when neostigmine was given at the end of
surgery. The aim of this study is to determine whether neostigmine use is associated with
muscle weakness when it is given at the time of nearly complete recovery from NMBAs. Muscle
strength will be measured using a sensitive monitor (TOF-Watch-SX) and through an examination
of the patient for evidence of muscle weakness. Patients will also be evaluated how they
recover from anesthesia and surgery.
Phase:
Phase 4
Details
Lead Sponsor:
NorthShore University HealthSystem NorthShore University HealthSystem Research Institute