EARLY AND LATE REVERSIBILITY OF ROCURONIUM BROMIDE

A computer simulation has been developed based on pharmacodynamic-phar macokinetic modelling of the effect of neostigmine on rocuronium-induc ed neuromuscular blockade. The results of a previous study involving 6 0 patients were used as a test of the model. The model predicts that a dministration of neostigmine 40 mug kg-1 within 20 min of the administ ration of rocuronium does not decrease the duration of the block until 90% recovery has taken place. The optimum dose of neostigmine depends on the degree of block at the time of administration: for a more inte nse block the optimum dose is 80 mug kg-1 and for a less intense block is about 30 mug kg-1. The pharmacokinetic behaviour rather than the p otency of the relaxant determines its reversibility.