title: A systematic review and meta-regression analysis of mivacurium for tracheal intubation.
abstract: We systematically reviewed factors associated with intubation conditions in randomised controlled trials of mivacurium, using random-effects meta-regression analysis. We included 29 studies of 1050 healthy participants. Four factors explained 72.9% of the variation in the probability of excellent intubation conditions: mivacurium dose, 24.4%; opioid use, 29.9%; time to intubation and age together, 18.6%. The odds ratio (95% CI) for excellent intubation was 3.14 (1.65-5.73) for doubling the mivacurium dose, 5.99 (2.14-15.18) for adding opioids to the intubation sequence, and 6.55 (6.01-7.74) for increasing the delay between mivacurium injection and airway insertion from 1 to 2 min in subjects aged 25 years and 2.17 (2.01-2.69) for subjects aged 70 years, p < 0.001 for all. We conclude that good conditions for tracheal intubation are more likely by delaying laryngoscopy after injecting a higher dose of mivacurium with an opioid, particularly in older people.
authors.affiliation: Department of Anaesthesiology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
authors.forename: L E H
authors.initials: LE
authors.lastname: Vanlinthout
authors.forename: S H
authors.initials: SH
authors.lastname: Mesfin
authors.forename: N
authors.initials: N
authors.lastname: Hens
authors.forename: B F
authors.initials: BF
authors.lastname: Vanacker
authors.forename: E N
authors.initials: EN
authors.lastname: Robertson
authors.forename: L H D J
authors.initials: LH
authors.lastname: Booij
mesh_terms: D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007546:Isoquinolines / Q000008:administration & dosage*; D008297:Male; D000077590:Mivacurium; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis
chemical_list: D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium