Recovery characteristics after early administration of anticholinesterases during intense mivacurium-induced neuromuscular block.
The time course of recovery after early administration of anticholinesterases during intense mivacurium-induced block was evaluated by recording the mechanomyographic response of the adductor pollicis to post-tetanic count (PTC) and train-of-four (TOF) ulnar nerve stimulation. Seventy-two adult patients receiving thiopentone, fentanyl, nitrous oxide, isoflurane anaesthesia and mivacurium 0.15 mg kg-1 were allocated randomly to one of six equal groups according to the type of anticholinesterase and intensity of block at which antagonism was attempted. Groups 1, 3 and 5 received neostigmine 0.07 mg kg-1, while groups 2, 4 and 6 received edrophonium 1 mg kg-1. At the time of administration of antagonist there was no response to PTC in groups 1 and 2, a PTC of 1 or more was detectable in groups 3 and 4 and the first twitch of the TOF (T1) had recovered to 10% in the conventional antagonism groups (5 and 6). The longest clinical duration (CD) values (time from administration of mivacurium to T1 25%) were encountered in groups 1, 5 and 6 and were 17.4 (7.9), 19.7 (3.4) and 21.4 (4.8) min, respectively. CD was reduced significantly in groups 2, 3 and 4 and values were 13.9 (3.5), 13.7 (3.5) and 13.8 (3.3) min, respectively. Recovery indices (RI) (time interval between T1 25% and 75%) were 13.8 (7.3), 6.3 (1.4), 4.6 (1.8), 6.0 (2.1), 3.7 (2.2) and 4.8 (3.1) min in groups 1-6, respectively and was prolonged with neostigmine antagonism at PTC 0 (group 1).(ABSTRACT TRUNCATED AT 250 WORDS)
Abdulatif
M
M
Department of Anaesthesia, Faculty of Medicine, Cairo University, Egypt.
D000293:Adolescent; D000328:Adult; D000762:Anesthesia Recovery Period; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D004491:Edrophonium / Q000008:administration & dosage; D004558:Electric Stimulation; D006801:Humans; D007546:Isoquinolines; D008875:Middle Aged; D000077590:Mivacurium; D009119:Muscle Contraction / Q000187:drug effects; D009388:Neostigmine / Q000008:administration & dosage; D009407:Nerve Block; D009466:Neuromuscular Blocking Agents; D009469:Neuromuscular Junction / Q000187:drug effects*; D003473:Neuromuscular Nondepolarizing Agents; D013997:Time Factors
D002800:Cholinesterase Inhibitors; D007546:Isoquinolines; D009466:Neuromuscular Blocking Agents; D003473:Neuromuscular Nondepolarizing Agents; D009388:Neostigmine; D004491:Edrophonium; D000077590:Mivacurium