Mivacurium compared with succinylcholine in children with liver disease.
We have compared mivacurium and succinylcholine in 27 paediatric patients with mild (Child's A) to moderate (Child's B) liver disease undergoing oesophagogastroduodenoscopy (OGD) and injection of oesophageal varices, with 10 healthy children receiving mivacurium for ENT procedures. With mivacurium 0.2 mg kg-1, the severity of liver disease did not correlate with duration of block compared with controls (time from bolus to T1 25%, P = 0.74; T1 25% to T4:T1 > 0.7, P = 0.545). However, initial recovery (time to T1 25%, P = 0.002) and overall recovery (bolus to T4:T1 > 0.7, P = 0.004) from mivacurium-induced neuromuscular block correlated inversely with pre-existing concentrations of plasma cholinesterase. Conditions for tracheal intubation at 2 min with mivacurium were comparable with conditions at 1 min with succinylcholine in the liver patients.
Green
D W
DW
Department of Anaesthetics, Intensive Care and Pain Relief, King's College Hospital, London.
Fisher
M
M
Sockalingham
I
I
D002648:Child; D002675:Child, Preschool; D002802:Cholinesterases / Q000097:blood; D016145:Endoscopy, Digestive System; D006801:Humans; D007442:Intubation, Intratracheal; D007546:Isoquinolines; D008107:Liver Diseases / Q000201:enzymology / Q000628:therapy*; D000077590:Mivacurium; D019148:Neuromuscular Blockade; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D011446:Prospective Studies; D013390:Succinylcholine
D007546:Isoquinolines; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D002802:Cholinesterases; D013390:Succinylcholine