Document Detail


Interactions between mivacurium, rocuronium, and vecuronium during general anesthesia.
MedLine Citation:
PMID:  8831328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was designed to examine the interactions between mivacurium and rocuronium or vecuronium when administered during a standardized anesthetic technique. Seventy healthy women undergoing abdominal hysterectomy procedures with a standardized thiopental-sufentanil-desflurane-nitrous oxide anesthetic technique were randomly assigned to one of seven treatment groups (10 patients each). After a tracheal intubating dose of vecuronium 100 micrograms/kg (Groups 1 and 2), rocuronium 600 micrograms/kg (Groups 3 and 4), or mivacurium 250 micrograms/kg (Groups 5, 6, and 7), patients received vecuronium, 25 micrograms/kg (Groups 1 and 6), rocuronium 150 micrograms/kg (Groups 3 and 7), or mivacurium 50 micrograms/kg (Groups 2, 4, and 5) for maintenance of neuromuscular blockade. Neuromuscular function was assessed using electromyography, with a train-of-four mode of stimulation at the wrist every 10 s. The clinical duration (time for T1 to return to 25% of baseline) of the maintenance dose of mivacurium was significantly longer after an intubating dose of rocuronium (40 +/- 8 min) and vecuronium (28 +/- 6 min) than after mivacurium (12 +/- 3 min). The clinical duration of maintenance doses of vecuronium (18 +/- 6 min) and rocuronium (13 +/- 2 min) were significantly shorter after an intubating dose of mivacurium than that after an intubating dose of vecuronium (30 +/- 5 min) or rocuronium (42 +/- 12 min), respectively. These data suggest that with consecutive administration of neuromuscular blocking drugs, the initial duration of action depends more on the kinetics of the first neuromuscular blocking drug than the subsequent drug. Thus, there appears to be no clinical advantage in using mivacurium for maintenance of neuromuscular blockade after initial administration of rocuronium or vecuronium.
Authors:
D W Kim; G P Joshi; P F White; E R Johnson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  83     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-11-05     Completed Date:  1996-11-05     Revised Date:  2004-11-18    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  818-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas 75235-9068, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Androstanols / administration & dosage*,  pharmacokinetics,  pharmacology
Anesthesia, General*
Anesthetics, Inhalation / administration & dosage
Anesthetics, Intravenous / administration & dosage
Drug Interactions
Electric Stimulation
Electromyography / drug effects
Female
Humans
Hysterectomy
Intubation, Intratracheal
Isoflurane / administration & dosage,  analogs & derivatives
Isoquinolines / administration & dosage*,  pharmacokinetics,  pharmacology
Middle Aged
Muscle Contraction / drug effects
Neuromuscular Junction / drug effects
Neuromuscular Nondepolarizing Agents / administration & dosage*,  pharmacokinetics,  pharmacology
Nitrous Oxide / administration & dosage
Sufentanil / administration & dosage
Thiopental / administration & dosage
Vecuronium Bromide / administration & dosage*,  pharmacokinetics,  pharmacology
Chemical
Reg. No./Substance:
0/Androstanols; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Isoquinolines; 0/Neuromuscular Nondepolarizing Agents; 10024-97-2/Nitrous Oxide; 106791-40-6/mivacurium; 143558-00-3/rocuronium; 26675-46-7/Isoflurane; 50700-72-6/Vecuronium Bromide; 56030-54-7/Sufentanil; 57041-67-5/desflurane; 76-75-5/Thiopental

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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