Early neuromuscular recovery characteristics following administration of mivacurium plus vecuronium.
OBJECTIVE
This study was designed to describe the early recovery characteristics, as well as the speed of onset of neuromuscular block, after a combination of mivacurium and vecuronium.


METHODS
In this controlled, randomized study, 30 consenting ASA I-III patients were assigned to three treatment groups. The "2M2V" group received twice the dose necessary to cause 95% depression of the evoked twitch response (2 x ED95) of mivacurium (0.15 mg.kg-1) plus 2 x ED95 of vecuronium (0.1 mg.kg-1); the "2V" group received 2 x ED95 of vecuronium; and the "4V" group received 4 x ED95 of vecuronium. Evoked neuromuscular responses of the adductor pollicis were assessed with an adductor pollicis force transducer. The time until maximum block and times to 10% and 25% recovery (T10 and T25) in each group were expressed as mean +/- standard deviation and compared using ANOVA.


RESULTS
Onset of block in the 2M2V group was 27% faster than in the 2V group (2.0 +/- 0.6 vs. 2.7 +/- 0.8 min respectively, P < 0.05) and was similar to the 4V group (1.95 +/- 0.3 min, P = NS). The times until 10% recovery were similar in the 2M2V and 4V groups (59.9 +/- 12 vs 68.2 +/- 25 min, P = NS) and were slower than in the 2V groups (37.2 +/- 9 min, P < 0.05). Between T10 and T25 recovery after 2M2V resembled that after 2V (6.7 +/- 3 vs 5.7 +/- 1 min, P = NS) and was faster than after 4V (10.9 +/- 7 min, P < 0.05).


CONCLUSIONS
When 2 x ED95 of mivacurium is added to 2 x ED95 of an intermediate or long-acting relaxant, recovery after T10 will proceed as if one had administered the longer-acting agent alone.
Stout
R G
RG
Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06520-8051, USA.
Brull
S J
SJ
Kelly
D
D
Silverman
D G
DG
D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage*; D000077590:Mivacurium; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D009469:Neuromuscular Junction / Q000187:drug effects*; D013997:Time Factors; D014673:Vecuronium Bromide / Q000008:administration & dosage*
D007546:Isoquinolines; D009467:Neuromuscular Depolarizing Agents; D000077590:Mivacurium; D014673:Vecuronium Bromide