Biomaterial Database

[Augmentation of the neuromuscular blocking effect of mivacurium during inhalation anesthesia with desflurane, sevoflorane and isoflurane in comparison with total intravenous anesthesia]. 1998

H Wulf, and S Hauschild, and D Proppe, and T Ledowski

Klinik für Anästhesiologie und Operative Intensivmedizin, Christian-Albrechts-Universität zu Kiel.

To evaluate the enhancement of mivacurium-induced neuromuscular block by potent inhalational anaesthetic agents, dose-effect curves for mivacurium were determined in 84 patients scheduled for minor elective surgery during anaesthesia with 1.5 MAC (70% N2O) desflurane, sevoflurane and isoflurane and compared with those under total intravenous anaesthesia (TIVA). Acceleromyography (TOF-Guard) and train of four (TOF) stimulation of the ulnar nerve were used (2 Hz every 12 s). Mivacurium was administered in increments of 25 micrograms kg-1 until a depression of T1 > 95% was reached. ANOVA was used for statistical analysis (alpha = 0.05, beta = 0.2). The depression of T1 during potent inhalational anaesthesia was enhanced compared with TIVA. The ED50 and ED95 of mivacurium were 27 +/- 11 (SD) and 58 +/- 26 micrograms kg-1 for desflurane; 28 +/- 10 and 64 +/- 23 micrograms kg-1 for sevoflurane; and 27 +/- 13 and 55 +/- 27 micrograms kg-1 for isoflurane and were significantly lower than the 35 +/- 7 and 71 +/- 20 micrograms kg-1 for TIVA. The duration 25% revealed a significant difference between the volatile anaesthetic groups (10 +/- 2, 11 +/- 3, 11 +/- 3 min respectively) and the TIVA control group (8 +/- 3 min). The recovery index 25/75 and TOFO.80 were significantly prolonged by desflurane, sevoflurane and isoflurane compared with TIVA (RI25/75 9 +/- 4, 9 +/- 4, 10 +/- 5 respectively vs. 5 +/- 2 min; TOFO.80 27 +/- 10, 28 +/- 9, 29 +/- 9 respectively vs. 18 +/- 4 min). We conclude that the neuromuscular blocking effect of mivacurium is enhanced during anaesthesia with desflurane, isoflurane and sevoflurane compared with TIVA. The duration of action and the recovery time are prolonged. The dose of mivacurium used should be reduced if anaesthesia is maintained with volatile anaesthetics.

UI	MeSH Term	Description	Entries
D007530	Isoflurane	A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
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)
D008297	Male		Males
D008738	Methyl Ethers	A group of compounds that contain the general formula R-OCH3.	Ethers, Methyl
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009126	Muscle Relaxation	That phase of a muscle twitch during which a muscle returns to a resting position.	Muscle Relaxations,Relaxation, Muscle,Relaxations, Muscle
D010038	Otorhinolaryngologic Diseases	Pathological processes of the ear, the nose, and the throat, also known as the ENT diseases.	Otolaryngologic Diseases,ENT Diseases,Otolaryngological Diseases,Otorhinolaryngologic Disease,Otorhinolaryngological Disease,Disease, ENT,Disease, Otolaryngologic,Disease, Otolaryngological,Disease, Otorhinolaryngologic,Disease, Otorhinolaryngological,Diseases, ENT,Diseases, Otolaryngologic,Diseases, Otolaryngological,Diseases, Otorhinolaryngologic,Diseases, Otorhinolaryngological,ENT Disease,Otolaryngologic Disease,Otolaryngological Disease,Otorhinolaryngological Diseases
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
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
D005260	Female		Females