Effects of divided doses of neostigmine on the dynamics of decurarization

In 37 patients the effect of neostigmine administered in divided doses (0.1 to 0.5 mg) on the dynamics of decurarization was studied by evaluating the tidal volume and respiratory rate. It was found that doses of neostigmine caused a continuous rise in tidal volume. Normalization of the tidal volume depended on the dose administered. The rate of decurarization depended also on the duration of the operation and the time of administration of the last d-tubocurarine dose. The proposed method of decurarization enables a safe reversal of d-tubocurarine effect to be obtained with a small dose of neostigmine.