Type I second-degree AV block after neostigmine administration in a child with renal failure.

Neostigmine is commonly used to reverse neuromuscular blockade. A side effect can be parasympathetic stimulation, which may result in heart block. Renal failure can decrease the clearance and increase the half-life of the drug, thus increasing the likelihood of a vagomimetic response. A case is presented where a child with renal failure developed a type I second-degree heart block after neostigmine was given.