Onset and duration of mivacurium-induced neuromuscular blockade in children with Charcot-Marie-Tooth disease. A case series with five children.
BACKGROUND
The Charcot-Marie-Tooth (CMT) disorders are a group of hereditary motor and sensory neuropathies characterized clinically by peripheral muscle wasting and weakness. We hypothesized that unknown involvement of the muscle used for monitoring neuromuscular block may account for the conflicting reports about the effect of nondepolarizing neuromuscular agents in these patients. The aim of this study was to compare onset and recovery from mivacurium-induced neuromuscular block on the adductor pollicis and orbicularis oculi muscles.


METHODS
We used mivacurium 0.2 mg.kg(-1) in five children (aged 7-12 years) with CMT type I undergoing propofol-fentanyl-oxygen-air anesthesia for orthopedic surgery. Using acceleromyography, neuromuscular transmission was monitored in parallel in the eye and thumb muscles, and onset and duration times were recorded.


RESULTS
Following bolus administration of 0.2 mg.kg(-1) of mivacurium the onset time ranged between 135 and 240 s and 75 and 165 s in the eye and in the thumb, respectively. The recovery time varied between 5.3 and 16 min and 6 and 31.3 min in the eye and in the thumb, respectively.


CONCLUSIONS
In our small series of patients with CMT the clinical duration of mivacurium-induced neuromuscular block was similar to data known from children without neuromuscular disease.
Schmitt
Hubert J
HJ
Department of Anaesthesiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. hubert.schmitt@kfa.imed.uni-erlangen.de
Wick
Stefanie
S
Münster
Tino
T
D000762:Anesthesia Recovery Period; D002607:Charcot-Marie-Tooth Disease / Q000601:surgery*; D002648:Child; D005123:Eye / Q000187:drug effects / Q000294:innervation; D005260:Female; D006801:Humans; D007546:Isoquinolines / Q000493:pharmacokinetics*; D008297:Male; D000077590:Mivacurium; D009213:Myography / Q000379:methods; D009407:Nerve Block / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000493:pharmacokinetics*; D013933:Thumb / Q000294:innervation; D013997:Time Factors
D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium