[Pharmacodynamics and safety of mivacurium in infants and children under halothane-nitrous oxide anesthesia].
OBJECTIVE
To determine pharmacodynamic effects and safety of mivacurium in paediatric patients.


METHODS
Multicentric, prospective, open, non-randomized study.


METHODS
Forty-eight three-month-old to eight-year-old physical class ASA I or II children.


METHODS
Anaesthesia was induced and maintained with halothane and nitrous oxide. Tracheal intubation was performed without a neuromuscular blocking agent. Neuromuscular blockade was measured with a strain force transducer after train-of-four stimulation of the ulnar nerve at the wrist every ten seconds. A single bolus dose of mivacurium (0.2 mg.kg-1) was injected during 15 seconds in patients allocated into three groups. Group 1: three to 12-month-old infants (n = 15), group 2: one- to three-year-old children (n = 16) and group 3: three- to eight-year-old children (n = 17). Onset and recovery parameters were measured in each patient. Heart rate and noninvasive arterial blood pressure were recorded every minute for five minutes after mivacurium injection.


RESULTS
Following halothane administration for 29 and 32 min, and a FEThalothane = 1 vol%, mivacurium (0.2 mg.kg-1) determined a 100% neuromusmcular blockade in all patients. The onset time was 71 +/- 34 s (mean +/- SD) in all patients and did not differ between groups. Time to 25% and 95% recovery of the first twitch and recovery index for all the patients were 12 +/- 3 min, 19 +/- 5 min and 4 +/- 2 min respectively and did not differ between groups. No prolonged paralysis was observed. No significant changes of HR and BP occurred.


CONCLUSIONS
Following 0.2 mg.kg-1 of mivacurium in patients aged between three months to eight years, a complete blockade occurs with a rapid onset time and a short duration of action, without significant cardiovascular effect.
Plaud
B
B
Département d'anesthésie-analgésie-réanimation, institut Gustave-Roussy, Villejuif, France.
Goujard
E
E
Orliaguet
G
G
Meistelman
C
C
Ecoffey
C
C
D018685:Anesthetics, Inhalation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006221:Halothane; D006801:Humans; D007223:Infant; D007546:Isoquinolines / Q000493:pharmacokinetics*; D008297:Male; D000077590:Mivacurium; D003473:Neuromuscular Nondepolarizing Agents / Q000493:pharmacokinetics*; D009609:Nitrous Oxide; D011446:Prospective Studies
D018685:Anesthetics, Inhalation; D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D009609:Nitrous Oxide; D006221:Halothane