Document Detail


Mivacurium infusion requirements in pediatric surgical patients during nitrous oxide-halothane and during nitrous oxide-narcotic anesthesia.
MedLine Citation:
PMID:  2141969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We were interested in determining the infusion rate of mivacurium required to maintain approximately 95% neuromuscular blockade during nitrous oxide-halothane (0.8% end-tidal) or nitrous oxide-narcotic anesthesia. Neuromuscular blockade was monitored by recording the electromyographic activity (Datex NMT) of the adductor pollicis muscle resulting from supramaximal stimulation of the ulnar nerve at 2 Hz for 2 s at 10-s intervals. Mivacurium steady-state infusion requirements averaged 315 +/- 26 micrograms.m-2.min-1 during nitrous oxide-halothane anesthesia and 375 +/- 19 micrograms.m-2.min-1 (mean +/- SEM) during nitrous oxide-narcotic anesthesia. Higher levels of pseudocholinesterase activity were generally associated with a higher mivacurium infusion requirement. During both anesthetics, younger age was associated with a higher infusion requirement when the infusion requirement was calculated in terms of micrograms.kg-1.min-1. This difference was not present when the infusion rate was calculated in terms of micrograms.m-2.m-1. There was no evidence of cumulation during prolonged mivacurium infusion. There was no difference in the rates of spontaneous or reversal-mediated recovery between anesthetic groups. After the termination of the infusion, spontaneous recovery to T4/T1 greater than or equal to 0.75 occurred in 9.8 +/- 0.4 min, with a recovery index, T25-75, of 4.0 +/- 0.2 min (mean +/- SEM). In summary, pseudocholinesterase activity is the major factor influencing mivacurium infusion rate in children during nitrous oxide-narcotic or nitrous oxide-halothane (0.8% end-tidal) anesthesia.
Authors:
B W Brandom; J B Sarner; S K Woelfel; M L Dong; M C Horn; L M Borland; D R Cook; V J Foster; B F McNulty; J N Weakly
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  71     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1990 Jul 
Date Detail:
Created Date:  1990-08-06     Completed Date:  1990-08-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  16-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Children's Hospital of Pittsburgh, PA 15213-2583.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Inhalation*
Child
Child, Preschool
Diazepam
Halothane*
Humans
Infusions, Intravenous
Isoquinolines*
Methohexital
Morphine
Neuromuscular Junction / drug effects*
Neuromuscular Nondepolarizing Agents / administration & dosage*,  therapeutic use
Nitrous Oxide*
Pediatrics
Pseudocholinesterase / metabolism
Scopolamine
Chemical
Reg. No./Substance:
0/Isoquinolines; 0/Neuromuscular Nondepolarizing Agents; 10024-97-2/Nitrous Oxide; 106791-40-6/mivacurium; 151-67-7/Halothane; 18652-93-2/Methohexital; 439-14-5/Diazepam; 51-34-3/Scopolamine; 57-27-2/Morphine; EC 3.1.1.-/Pseudocholinesterase

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


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