Mivacurium: dose-response relationship and administration by repeated injection or infusion.
The dose-response relationship and neuromuscular blockade after infusion or repeated injection of mivacurium were studied in 65 patients in nitrous oxide-narcotic anesthesia. The ED95 (twitch tension) was determined in 45 patients by intravenous injection of a single bolus of 30, 39, 47, 54, or 60 micrograms/kg (9 patients per dose). Another 20 patients received an initial bolus of 2 x ED95 followed either by an infusion started at 5% twitch recovery (i.e., 95% depression) and adjusted to sustain 95% twitch depression (n = 10) or by repeated injection of 0.6 x ED95 whenever twitch tension had recovered to 25% of control (n = 10). Five patients in each of these two groups received 7 micrograms/kg of neostigmine at 25% twitch recovery, and the others recovered twitch tension spontaneously. The mean ED95 was 73 micrograms/kg. A 2 x ED95 bolus was followed by complete twitch depression within 2.2 +/- 0.7 min. The mean infusion rate resulted in 6 +/- 2 micrograms.kg-1.min-1. The ensuing recovery index was 6 +/- 3 min. A 6 +/- 2 min recovery index was found after up to 10 repeat injections given every 9 +/- 3 min. There was no significant effect of neostigmine in both groups. In conclusion, the recovery indices after the infusion or repeat injection of near-equal doses of mivacurium were identical.
Diefenbach
C
C
University Department of Anesthesiology, Koeln, Germany.
Mellinghoff
H
H
Lynch
J
J
Buzello
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D007546:Isoquinolines; D008297:Male; D008875:Middle Aged; D000077590:Mivacurium; D009126:Muscle Relaxation / Q000187:drug effects; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage*; D009467:Neuromuscular Depolarizing Agents / Q000037:antagonists & inhibitors*; D009469:Neuromuscular Junction / Q000502:physiology; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D009435:Synaptic Transmission / Q000187:drug effects
D007546:Isoquinolines; D009466:Neuromuscular Blocking Agents; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium