title: Different F-wave recovery after neuromuscular blockade with pancuronium and mivacurium.
abstract: We performed this study to assess the recovery period after neuromuscular blockade by electromyographic F-wave analysis, a method that supplies more information about more proximal parts of the motor system than conventionally used methods, e.g., mechanomyography (MMG). In 20 neurosurgical ASA physical status I or II patients anesthesia was induced and maintained with IV fentanyl and midazolam. Patients were randomly assigned to receive either 0.25 mg/kg mivacurium (MV group, n = 10) or 0.1 mg/kg pancuronium (PC group, n = 10) intraoperatively. MMG monitoring of the adductor pollicis muscle was performed continuously. F waves were recorded at the abductor pollicis muscle of the contralateral hand at train-of-four (TOF) ratios of 0.1, 0.25, 0.5, 0.7, 0.75, 0.8, 0.85, 0.9, and 0.95. Recovery of F-wave amplitudes after neuromuscular blockade with pancuronium was significantly slower compared with mivacurium (P = 0.004) during the clinically important recovery period defined by MMG TOF ratios from 0.7 to 0.95. This electrophysiologic finding suggests a differential recovery of the motor system after administration of pancuronium and mivacurium not detected by MMG.
authors.affiliation: Department of Anesthesiology, University of Cologne, Cologne, Germany.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Dueck
authors.forename: Matthias
authors.initials: M
authors.lastname: Paul
authors.forename: Philipp
authors.initials: P
authors.lastname: Sagawe
authors.forename: Aloys
authors.initials: A
authors.lastname: Oberthuer
authors.forename: Christoph
authors.initials: C
authors.lastname: Wedekind
authors.forename: Ulf
authors.initials: U
authors.lastname: Boerner
mesh_terms: D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D004311:Double-Blind Method; D004558:Electric Stimulation; D004576:Electromyography; D005260:Female; D006801:Humans; D007546:Isoquinolines; D008297:Male; D008875:Middle Aged; D000077590:Mivacurium; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents; D010197:Pancuronium; D010525:Peripheral Nerves / Q000502:physiology
chemical_list: D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D010197:Pancuronium