Neuromuscular and cardiovascular effects of mivacurium in children.
The neuromuscular and cardiovascular effects of mivacurium chloride (BW B1090U) were evaluated in 90 children (2-12 yr) during N2O:O2 halothane or N2O:O2 narcotic anesthesia. Neuromuscular response was evaluated by recording the force of contraction of the adductor of the thumb during train-of-four stimulation at 0.1 Hz. The children were divided into two groups. Patients in group A (n = 45) were anesthetized with N2O:O2 and halothane (1% inspired) and patients in group B (n = 45) were anesthetized with N2O:O2 and fentanyl or morphine. Each group was further divided into five subgroups of nine children. Children in the first three sets of subgroups (A1-A3, B1-B3) received an initial dose of 0.02, 0.04, 0.05, 0.06 or 0.07 mg/kg mivacurium to determine dose response relationships under the different anesthetic regimens. The ED50 and ED95 neuromuscular blocking doses calculated from this single dose technique were 0.051 mg/kg and 0.095 mg/kg, respectively, in children anesthetized with halothane N2O:O2, and 0.059 mg/kg and 0.11 mg/kg in children anesthetized with N2O:O2 narcotic. The fourth subset of each group (A4 and B4) received 0.09 mg/kg and 0.11 mg/kg mivacurium, the estimated ED95 for each respectively. The last subsets (A5 and B5) received 0.2 mg/kg. This dose induced 100% depression of the twitch response in all 18 patients in 1.8 +/- 0.1 min, with recovery to 5%, 25%, and 95% of control occurring in 8.4 +/- 0.5, 11.2 +/- 0.6 and 18.4 +/- 1.6 min, respectively. The recovery indices for all patients were 4.6 +/- 0.6 min for 25-75% recovery and 9.7 +/- 1.3 min for 5-95% recovery.(ABSTRACT TRUNCATED AT 250 WORDS)
Goudsouzian
N G
NG
Department of Anaesthesia, Harvard Medical School, Massachusetts General Hospital, Boston 02114.
Alifimoff
J K
JK
Eberly
C
C
Smeets
R
R
Griswold
J
J
Miler
V
V
McNulty
B F
BF
Savarese
J J
JJ
D000758:Anesthesia; D002319:Cardiovascular System / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D005283:Fentanyl; D006221:Halothane; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007546:Isoquinolines; D000077590:Mivacurium; D009020:Morphine; D009469:Neuromuscular Junction / Q000187:drug effects*; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D009609:Nitrous Oxide; D010100:Oxygen
D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D009020:Morphine; D000077590:Mivacurium; D009609:Nitrous Oxide; D010100:Oxygen; D005283:Fentanyl; D006221:Halothane