Reversal of combination nondepolarized neuromuscular block

The antagonism of a pancuronium-curare (P + C) neuromuscular block was assessed and compared to the antagonism of a pancuronium (P) block. One group of seven patients received P + C (0.024 mg/kg + 0.144 mg/kg); another similar group of seven patients received P (0.07 mg/kg). Both groups were anesthetized with nitrous oxide/oxygen/narcotic anesthesia. Each patient received 0.025 mg/kg of neostigmine when a train-of-four revealed only one twitch (90% block). The resultant antagonism of the pancuronium-curare blocks was the same as the antagonism of the pancuronium blocks (train-of-four ratio, 0.38 vs 0.32; P = 0.5). The authors conclude that neostigmine requirements for combination blocks are the same as those for single agent blocks.