Dose-response relationship for mivacurium in patients with phenotypically abnormal plasma cholinesterase activity.
During thiopentone-fentanyl-nitrous oxide anaesthesia and using a cumulative design, we studied the dose-response relationship of mivacurium in 8 patients: 7 patients phenotypically homozygous for the atypical plasma cholinesterase gene and 1 patient homozygous for the silent gene. The estimated mean ED50 and ED95 were 15 and 20 micrograms.kg.bw-1 in patients homozygous for the atypical gene, and 13 and 16 micrograms.kg.bw-1 in the patient homozygous for the silent gene, respectively. The results indicate that mivacurium is 4-5 times more potent in patients homozygous for the atypical or the silent gene than in patients with normal plasma cholinesterase activity and phenotype.
Ostergaard
D
D
Danish Cholinesterase Research Unit, Department of Anaesthesia, National University Hospital, Rigshospitalet, Denmark.
Jensen
F S
FS
Skovgaard
L T
LT
Viby-Mogensen
J
J
D000328:Adult; D002802:Cholinesterases / Q000097:blood* / Q000235:genetics; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007546:Isoquinolines / Q000494:pharmacology*; D008875:Middle Aged; D000077590:Mivacurium; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D010641:Phenotype
D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D002802:Cholinesterases