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Anesth Analg 1988; 67:495-499
© 1988 International Anesthesia Research Society
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Mivacurium Chloride (BW B1090U)-Induced Neuromuscular Blockade During Nitrous Oxide–Isoflurane and Nitrous Oxide—Narcotic Anesthesia in Adult Surgical Patients

Stanley Weber, MD, Barbara W. Brandom, MD, Danae M. Powers, MD, Joel B. Sarner, MD, Susan K. Woelfel, MD, D. Ryan Cook, MD, Vicki J. Foster, MSPH, Barbara F. McNulty, MPH, and J. Neal Weakly, PhD

Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; the Division of Anesthesiology, Allegheny General Hospital, Pittsburgh, Pennsylvania; and the Division of Clinical Research, Burroughs Wellcome Company, Research Triangle Park, North Carolina.

Abstract

The neuromuscular and cardiovascular effects of mivacurium were studied in 90 adult patientsduring nitrous oxide-oxygen-isoflurane In = 45, ISO group) and nitrous oxide-oxygen-narcotic (n = 45, BAL group) anesthesia. Neuromuscular blockade was measured using electromyographic activity of the adductor pollicis muscle after supra-maximal stimulation of the ulnar nerve at 2 Hz for2 seconds at 10-second intervals. To estimate dose-response relations, three subgroups of nine patients in the ISO group received mivacurium doses of 0.025, 0.03, and 0.04 mg/kg, respectively. Similarly, three subgroups of nine patients in the BAL group received mivacurium doses of 0.03, 0.04, and 0.05 mg/kg, respectively. The ED50 and ED95 of mivacurium in each group were estimated from linear regression plots of log dose vs probit of maximum percentage depression of neuromuscular function. The estimated ED50 values for the ISO and BAL groups were 0.029 and 0.041 mg/kg, respectively. The estimated ED95 values for the ISO and BALgroups were 0.045 and 0.058 mg/kg, respectively. Recovery indexes were measured in 26 patients who received ED95 or greater doses of mivacurium in either the ISO or BAL groups. The recovery index was shorter in the BAL group (5.5 ± 1.6 minutes In = 10]), than in the ISO group (7.4 ± 3.0 minutes [n = 261). The addition of isoflurane (0.5–0.75% end-tidal concentration) to nitrous oxide-narcotic anesthesia augments the degree of neuromuscular blockade froma given dose of mivacurium and also prolongs the recovery index.

Key Words: NEUROMUSCULAR RELAXANTS—mivacurium






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.