[Continuous administration of mivacurium for short procedures. Delayed onset and recovery from neuromuscular blockade].
OBJECTIVE
To assess the delays of onset and spontaneous recovery from neuromuscular block produced by mivacurium administered by continuous infusion for short procedure requiring a deep relaxation.


METHODS
Prospective open non comparative study.


METHODS
Twenty-nine class ASA I and II adults undergoing a stomatological procedure of short duration were included in the study.


METHODS
General anaesthesia was obtained with a continuous infusion of propofol, supplemented with alfentanil and N2O-O2 mixture. Neuromuscular blockade, assessed with electromyography of the adductor pollicis muscle, was obtained with mivacurium (150 micrograms.kg-1). After restoration of 5% of neuromuscular transmission, mivacurium was administered by continuous infusion in order to maintain a blockade between 91 and 99%.


RESULTS
The delay for decreasing twitch height by 95% was 2.9 +/- 1.0 min. The mean dose for maintenance of blockade was 10.9 +/- 1.5 micrograms.kg-1.min-1. The delay of spontaneous recovery from blockade was 10.2 min, 16.6 min and 21.3 min for obtaining 25, 75 and 95% twitchs respectively. The delay for the twitch increase from 25 to 75% was 6.6 min.


CONCLUSIONS
Mivacurium in continuous infusion provides rapidly a deep and stable neuromuscular blockade followed by a rapid spontaneous restoration of neuromuscular transmission in patients with normal pseudocholinesterases.
Pellissier
D
D
Département d'Anesthésie-Réanimation Chirurgicale, Hôpital Timone Adultes, Marseille.
Bruder
N
N
Mokart
D
D
Quilichini
D
D
Camatte
S
S
Blache
J L
JL
François
G
G
D000328:Adult; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental / Q000379:methods; D000768:Anesthesia, General / Q000379:methods*; D002091:Butyrylcholinesterase / Q000097:blood; D003692:Delayed-Action Preparations / Q000494:pharmacology; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage* / Q000378:metabolism / Q000494:pharmacology; D000077590:Mivacurium; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage* / Q000378:metabolism / Q000494:pharmacology; D011446:Prospective Studies
D003692:Delayed-Action Preparations; D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D002091:Butyrylcholinesterase
Mivacurium en administration continue pour des actes courts. Délais d'installation et de régression du bloc neuromusculaire.