Irreversible tubocurarine neuromuscular block in the human

The effect of neostigmine on different degrees of tubocurarine block has been inves-tigated in eight hyperventilated patients under nitrous oxide anaesthesia. The degree of reversal depended on the plasma level of tubocurarine and on the degree of neuro-muscular block present at the time of reversal. Neostigmine could not reverse doses of tubocurarine that were much greater than the blocking dose. Neostigmine-resistant curarization has been des-cribed by Hunter (1956). Churchill-Davidson (1959), however, stressed the fact that there are many causes of prolonged cessation of respiration, and before the term "neostigmine-resistant cura-rization " can be accepted it is first necessary to prove that a neuromuscular block was in fact present, and secondly that neostigmine failed to reverse the blockade. Using the isolated phrenic nerve diaphrag