title: Priming technique accelerates the onset time of mivacurium in children during halothane anesthesia.
abstract: BACKGROUND
  Mivacurium is considered a relaxant suitable for tracheal intubation in children due to its rapid onset. We compared the neuromuscular effects of mivacurium, with and without priming, in children undergoing elective surgery during halothane anesthesia.
  
  
  METHODS
  Forty pediatric patients (2-10 yr, ASA class I) were randomly into 2 groups and studied under halothane anesthesia. The non-priming group (n = 20) received mivacurium 0.25 mg/kg, and the priming group (n = 20) received a priming dose of mivacurium 0.025 mg/kg, followed by an intubating dose of 0.225 mg/kg 3 min later. Thenar Electromyogram responsive to supramaximal train-of-four stimulation of the ulnar nerve at 12 s intervals was used as neuromuscular monitoring.
  
  
  RESULTS
  The onset time in the priming group was significantly faster than in the non-priming group (1.04 min vs. 1.7 min). The mean time from injection of intubating dose to spontaneous recovery to 25%, 50% and 75% twitch were not influenced by priming technique. Side effects, such as cutaneous flushing and hypotension, were unremarkable at this dose in children.
  
  
  CONCLUSIONS
  Priming technique can significantly accelerates the onset of mivacurium in the pediatric patients under halothane anesthesia.
authors.affiliation: Department of Anesthesiology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
authors.forename: Y C
authors.initials: YC
authors.lastname: Chu
authors.forename: S M
authors.initials: SM
authors.lastname: Lin
authors.forename: Y C
authors.initials: YC
authors.lastname: Huang
authors.forename: K W
authors.initials: KW
authors.lastname: Hui
authors.forename: S K
authors.initials: SK
authors.lastname: Tsai
authors.forename: T Y
authors.initials: TY
authors.lastname: Lee
mesh_terms: D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006221:Halothane / Q000494:pharmacology*; D006801:Humans; D007546:Isoquinolines / Q000494:pharmacology*; D008297:Male; D000077590:Mivacurium; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D006221:Halothane