The antagonism of neuromuscular blocking agents (NMBA) (or curares), as well as the
antagonism of other drugs used in anesthesia, is a major challenge for the speciality.
Residual paralysis is indeed a risk factor for post-operative morbidity and mortality and
antagonization of curares at the end of the procedure is associated with a reduction in
Its use should be as large as possible and its contraindications are extremely rare.
The antagonism of the NMBA reduces the duration of the neuromuscular block and the
complications that are associated .
In this study, the investigators use mivacurium (or Mivacron) as non-depolarizing curare and
neostigmine as an antagonist.
Neostigmine reduces the duration of the neuromuscular block induced by mivacurium, By
reducing the breakdown of acetylcholine, neostigmine induces an increase in acetylcholine in
the synaptic cleft which competes for the same binding site as nondepolarizing neuromuscular
blocking agents, and reverses the neuromuscular blockade.
But the use of neostigmine in current practice is not very widespread in this clinical
The reduction in the duration of the block is significant in comparison with a spontaneous
Moreover, spontaneous recovery is not always complete and sometimes very long.
Nevertheless, its action is effective and this study could support this use but also specify
the duration and the quality of the return to normal of the neuromuscular transmission.