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Korean Journal of Anesthesiology 1999;36(3):412-416.
DOI: https://doi.org/10.4097/kjae.1999.36.3.412   
Reversal of Neuromuscular Blockade with Neostigmine Does not Increase the Incidence of Postoperative Nausea and Vomiting.
Byung Hee Lee
Department of Anesthesiolgy, Pundang CHA General Hospital, College of Medicine, University of Pochon CHA, Sungnam, Korea.
Abstract
BACKGROUND
Postoperative nausea and vomiting (PONV) are still very common complications after general anesthesia. Some studies have reported that reversal of neuromuscular block by neostigmine is an important factor contributing to PONV. Whereas other studies have shown that when neostigmine is given as a reversal for muscle relaxation using mivacurium, it does not contribute to the incidence and severity of PONV. This study was designed to compare the reversible effect of neuromuscular block using neostigmine with the spontaneous recovery of neuromuscular block on the incidence and severity of PONV.
METHODS
Sixty female patients undergoing laparoscopic zygote intra-fallopian transfer were studied and were allocated randomly into two groups. In Group 1 (n=30), neuromusclar block produced by mivacurium was antagonized by 1.5 mg neostigmine and 0.4 mg glycopyrrolate intravenously, whereas Group 2 (n=30) received no drugs to facilitate antagonism of blockade. The incidence and severity of PONV was assessed up to 3 hours after the operation.
RESULTS
Both groups were comparable, and no differences were found in age, weight, duration of anesthesia, and the amount of mivacurium given during surgery. There were no significant differences between the two groups in the incidence and severity of PONV.
CONCLUSION
This investigation has shown that when neostigmine is given as a reversal for muscle relaxation with mivacurium, it does not contribute to the incidence and severity of PONV.
Key Words: Antagonist, neuromuscular relaxants, neostigmine; Vomiting, incidence, postoperative


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