Comparison of the neuromuscular block induced by mivacurium, suxamethonium or atracurium during nitrous oxide-fentanyl anaesthesia. 1989

J E Caldwell, and T Heier, and J B Kitts, and D P Lynam, and M R Fahey, and R D Miller
Department of Anesthesia, University of California, San Francisco 94143-0648.

We compared the neuromuscular and cardiovascular changes following administration of mivacurium 0.15, 0.20 and 0.25 mg kg-1, suxamethonium 1.0 mg kg-1 or atracurium 0.5 mg kg-1 i.v. in 41 (ASA physical status I or II) patients during nitrous oxide-fentanyl anaesthesia. Mean onset times for total ablation of twitch response for mivacurium 0.15, 0.20 and 0.25 mg kg-1, were 2.5, 2.4 and 2.7 min, respectively, similar to that for atracurium (2.5 min), but longer than for suxamethonium (1.1 min) (P less than 0.05). Mean times from administration of drug until twitch response recovered to 10% of control were shorter for each dose of mivacurium (15.6, 18.0 and 20.6 min, respectively) than for atracurium (40.0 min) and longer than for suxamethonium (7.7 min) (P less than 0.05). Mean infusion rate required to maintain twitch response at 5 +/- 4% control was 6.7 micrograms kg-1 min-1 for mivacurium and 6.3 micrograms kg-1 min-1 for atracurium. Following neostigmine 0.045 mg kg-1, mean times for twitch tension to recover from 10% to 90% of control were similar for mivacurium (9.7 min) and atracurium (10.5 min). Transient decreases in mean arterial pressure (greater than 20%) were observed in seven of 15 patients who received the two higher doses of mivacurium.

UI MeSH Term Description Entries
D007546 Isoquinolines A group of compounds with the heterocyclic ring structure of benzo(c)pyridine. The ring structure is characteristic of the group of opium alkaloids such as papaverine. (From Stedman, 25th ed)
D009119 Muscle Contraction A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. Inotropism,Muscular Contraction,Contraction, Muscle,Contraction, Muscular,Contractions, Muscle,Contractions, Muscular,Inotropisms,Muscle Contractions,Muscular Contractions
D009609 Nitrous Oxide Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream. Laughing Gas,Nitrogen Protoxide,Gas, Laughing,Oxide, Nitrous
D003473 Neuromuscular Nondepolarizing Agents Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants. Curare-Like Agents,Curariform Drugs,Muscle Relaxants, Non-Depolarizing,Neuromuscular Blocking Agents, Competitive,Nondepolarizing Blockers,Agents, Curare-Like,Agents, Neuromuscular Nondepolarizing,Blockers, Nondepolarizing,Curare Like Agents,Drugs, Curariform,Muscle Relaxants, Non Depolarizing,Non-Depolarizing Muscle Relaxants,Nondepolarizing Agents, Neuromuscular
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077590 Mivacurium An isoquinoline derivative that is used as a short-acting non-depolarizing agent. BW B1090U,BW-B 1090U,BW-B-1090U,BW-B1090U,Mivacron,Mivacurium Chloride,BW B 1090U,BWB 1090U,BWB1090U
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias
D000769 Anesthesia, Inhalation Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract. Insufflation Anesthesia,Anesthesia, Insufflation,Inhalation Anesthesia
D001279 Atracurium A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents. Atracurium Besylate,Atracurium Dibesylate,33 A 74,Atracurium Besilate,BW-33A,Relatrac,Tracrium,A 74, 33,BW 33A,BW33A,Besilate, Atracurium

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