Can 4-aminopyridine be used to reverse anaesthesia and muscle relaxation?

4-aminopyridine has earlier been shown to antagonize neuromuscular block and to release transmitters in CNS. In a study in man the drug was given intravenously at the end of anaesthesia in order to counteract muscle relaxation and possibly also anaesthesia. The effects were followed by clinical observations, intraarterial blood pressure recording, ECG, repetitive muscle nerve stimulation and EEG. It was shown that the drug could reverse the neuromuscular block in lightly curarized patients, but was not as efficient as synstigmine methylsulphate (Neostigmine). In two cases the drug produced a slowing of EEG activity, which was normalized by naloxone. No toxic effects of the drug were observed.