Recovery from SCh-induced depolarizing blockade

Recovery from SCh-induced depolarizing blockade usually occurs within 5 to 10 minutes following a 1 mg/kg IV dose. Patients with atypical or inhibited plasma cholinesterase could have a greatly prolonged duration of blockade. Reversal of phase II blockade occurs spontaneously within 10 to 15 minutes in approximately 50% of patients. It is advisable to allow patients with prolonged blockade to recover spontaneously for 20 to 25 minutes and then reversal with an anticholinesterase agent may be attempted if there is no further improvement in twitch strength. Earlier reversal could potentiate the block.