Cholinesterase inhibitors do not prolong neuromuscular block produced by mivacurium

Neal Fleming, Brock K. Lewis

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Cholinesterase inhibitors antagonize neuromuscular block produced by mivacurium, but some may also decrease its metabolism by inhibiting pseudocholinesterase. These opposing interactions were examined in rats anaesthetized with pentobarbitone. After spontaneous recovery from an initial bolus dose of 0.03 mg kg-1, mivacurium was infused to produce 80-90% block of gastrocnemius muscle twitch. After 15 min, the infusion was discontinued and saline, edrophonium. pyridostigmine or neostigmine was administered. Fifteen minutes later, a second bolus dose of mivacurium was given. Edrophonium, pyridostigmine and neostigmine reduced the subsequent maximum block, compared with the change in saline control, by 3%, 19% and 35%, respectively. Correspondingly, the time to recovery of T1 to 50% was decreased by 20%, 58% and 62%. In rats, acetylcholinesterase mediated antagonism of neuromuscular block predominated over decreased pseudocholinesterase mediated metabolism, such that prior administration of a cholinesterase inhibitor did not prolong the neuromuscular blocking effects of mivacurium.

Original languageEnglish (US)
Pages (from-to)241-243
Number of pages3
JournalBritish Journal of Anaesthesia
Issue number2
StatePublished - Aug 1994


  • Antagonists, neuromuscular block pyridostigmine
  • Antagonists, neuromuscular block: edrophonium
  • Antagonists, neuromuscular block: neostigmine
  • Enzymes cholinesterase
  • Neuromuscular block. mivacurium

ASJC Scopus subject areas

  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Mathematics(all)
  • Statistics and Probability
  • Agricultural and Biological Sciences (miscellaneous)
  • Anesthesiology and Pain Medicine


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