[Value of the monitoring of curarisation during prolonged mivacurium induced neuromuscular block].
A case of neuromuscular blockade of about 200 min of duration, in a 9-year-old boy from mivacurium 0.15 mg.kg-1 is reported. The diagnosis was delayed, after onset of the first signs of recovery, due to the lack of monitoring of neuromuscular transmission. The neuromuscular blockade was reversed with neostigmine 0.04 mg.kg-1. Complete reversal required fifty minutes. The presence of an abnormal genetic variant of pseudocholinesterases was demonstrated by the measurements of pseudocholinesterase activity and dibucaine number. The importance of monitoring of neuromuscular transmission for diagnosis and treatment of mivacurium-induced neuromuscular blockade is underlined.
Avargues
P
P
Département d'Anesthésie-Réanimation IV, Hôpital Pellegrin, Enfants, Bordeaux.
Cros
A M
AM
Dardel
E
E
Darriet
M
M
Biteau
N
N
D000762:Anesthesia Recovery Period; D002091:Butyrylcholinesterase / Q000097:blood / Q000235:genetics; D002648:Child; D006720:Homozygote; D006801:Humans; D007546:Isoquinolines / Q000378:metabolism* / Q000494:pharmacology; D008297:Male; D000077590:Mivacurium; D016343:Monitoring, Intraoperative; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000378:metabolism* / Q000494:pharmacology; D014068:Tonsillectomy
D007546:Isoquinolines; D009125:Muscle Relaxants, Central; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D002091:Butyrylcholinesterase
Intérêt du monitorage de la curarisation lors d'un bloc neuromusculaire prolongé par mivacurium.