Table 1.
Baseline clinical data in the first column are compared to stable level of neuromuscular blockade by mivacurium as measured by adductor pollicis TOF (train-of-four) ratios and clinical impairment represented in the second (middle) column, and the third column shows the clinical response to intranasal neostigmine. Intranasal neostigmine antagonized the neuromuscular blockade as measured by TOF ratios and also improved all clinical levels of muscle function prior to termination of the mivacurium infusion. A constant rate of mivacurium infusion combined with stabilized TOF ratio and clinical impairment made it possible to compare changes attributable to the administration of intranasal neostigmine
| Baseline | Stable Clinical Dysfunction + Stable Neuromuscular Blockade (TOF ratio) | Response to Intranasal Neostigmine | |
|---|---|---|---|
| Mivacurium Infusion Rate | 0 | 2.5 mcg/kg/min | 2.5 mcg/kg/min |
| Normalized TOF ratios (mean ± SD) | 1.00 | 0.56 ± 0.02 | 0.64 ± 0.03 |
| Range 0.51–0.58 | Range 0.61–0.70 | ||
| 95% CI (0.54–0.57) | 95% CI (0.63–0.66) | ||
| Visual Acuity | 20/20 | >20/200 | 20/20 |
| Ease of Swallowing | Easy | Difficult | Easy |
| Neck Flexion (Head Raise >5 s) | Easy (+) | Unable (-) | Easy (+) |
| Peak Flow | 100% | 72% | 91% |
| CI 95% (64.72–78.61) | CI 95% (85.24–97.26) | ||
| Jaw Ptosis | None | Present | None |
| Tongue Protrusion | Easy | Moderately Difficult | Easy |
| Diction | Normal | Poor | Improved |