L’anesthésie intraveineuse totale avec le propofol augmente la puissance du mivacurium

Hemmerling, Thomas M.; Lê, Nhiên; Decarie, Patrick; Cousineau, Julie; Bracco, David

doi:10.1007/bf03021490

Cited by 8 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hemmerling et al. reported on a clinically relevant effect of propofol and the length of propofol anaesthesia on mivacurium potency (augmentation after 20 min approximately 1.5‐fold) and mentioned the conflicting data on whether or not propofol directly affects peripheral muscle contractility [23]. Our results suggest a positive interaction, considering the comparatively low mivacurium requirements in this first simultaneous controlling of anaesthesia depth and neuromuscular blockade.…”

Section: Discussionsupporting

confidence: 47%

Clinical evaluation of a simultaneous closed-loop anaesthesia control system for depth of anaesthesia and neuromuscular blockade*

et al. 2011

View full text Add to dashboard Cite

SummaryWe developed a closed-loop system to control the depth of anaesthesia and neuromuscular blockade using the bispectral index and the electromyogram simultaneously and evaluated the clinical performance of this combined system for general anaesthesia. Twenty-two adult patients were included in this study. Anaesthesia was induced by a continuous infusion of remifentanil at 0.4 lg.kg )1 .min )1 (induction dose) and then 0.25 lg.kg )1 .min )1 (maintenance dose) and propofol at 2 mg.kg )1 3 min later. The combined automatic control was started 2 min after tracheal intubation. The depth of anaesthesia was recorded using bispectral index monitoring using a target value of 40. The target value of neuromuscular blockade, using mivacurium, was a T1 ⁄ T1 0 twitch height of 10%. The precision of the system was calculated using internationally defined performance parameters. Twenty patients were included in the data analysis. The mean (SD) duration of simultaneous control was 129 (69) min. No human intervention was necessary during the computer-controlled administration of propofol and mivacurium. All patients assessed the quality of anaesthesia as 'good' to 'very good'; there were no episodes of awareness. The mean (SD) median performance error, median absolute performance error and wobble for the control of depth of anaesthesia and for neuromuscular blockade were )0

show abstract

Section: Discussionsupporting

confidence: 47%

Clinical evaluation of a simultaneous closed-loop anaesthesia control system for depth of anaesthesia and neuromuscular blockade*

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Since it was generally agreed that intravenous anaesthetic agents do not potentiate the paralysing effects of NMBAs, there are only two clinical studies investigating the impact of the duration of intravenous anaesthesia on neuromuscular blockade . Plaud et al.…”

Section: Discussionmentioning

confidence: 99%

“…Since only the sub‐paralytic dose of 0.1 mg/kg mivacurium was investigated, the authors clearly proved that the effect of this specific dose is enhanced after 15 min of propofol anaesthesia, but could not provide any information about the interaction between propofol and mivacurium. Another study focussed on the dose–effect relation of mivacurium dependent on the duration of propofol infusion monitored by phonemyography . The potency of mivacurium was significantly increased (approximately 1.5‐fold) after total intravenous anaesthesia (TIVA) with propofol for 20 min compared with 5 min .…”

Section: Discussionmentioning

confidence: 99%

Effects of single‐shot and steady‐state propofol anaesthesia on rocuronium dose–response relationship: a randomised trial

Stäuble

Schaller

et al. 2015

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

CitationSt€ auble CG, St€ auble RB, Schaller SJ, Unterbuchner C, Fink H, Blobner M. Effects of single-shot and steady-state propofol anaesthesia on rocuronium dose-response relationship: a randomised trial. ActaBackground: Similar to volatile anaesthetics, propofol may influence neuromuscular transmission. We hypothesised that the administration of propofol influenced the potency of rocuronium depending on the duration of the administration. Methods: After consent, patients scheduled for elective surgery randomly received rocuronium either after induction of anaesthesia with propofol (2 min of propofol, n = 36) or after 30 min of propofol infusion (30 min of propofol, n = 36). Remifentanil was given in both groups. Neuromuscular monitoring was performed by calibrated electromyography. The dose-response relationship of rocuronium was determined with a single-bolus technique (0.07, 0.1, 0.15, 0.2, 0.3 and 0.45 mg/kg rocuronium). The primary endpoints were the ED 50 and ED 95 of rocuronium after 2 and 30 min propofol. Data are presented as means with (95% confidence interval). The trial is registered with the Eudra-CT: 2009-012815-16. Results: A total of 72 patients were included. Time to maximal neuromuscular blockade was significantly shorter in patients after 30 min of propofol [3.3 min (2.9-3.7)] compared with patients anaesthetised with 2 min of propofol [4.6 min (4.0-5.2)]. After 30 min of propofol, the slope of the dose-response curve was significantly steeper (30 min of propofol: 4.34 [3.62-5.05]; 2 min of propofol: [3.34 (2.72-3.96)], resulting in lower ED 95 values of rocuronium (30 min of propofol: 0.287 mg/kg [0.221-0.368]; 2 min of propofol [0.391 mg/kg (0.296-0.520)]. The ED 50 were not different between groups. Conclusion: The potency of rocuronium was significantly enhanced after propofol infusion for 30 min. Estimates of potency those are usually determined during steady-state anaesthesia might underestimate rocuronium requirements for endotracheal intubation at the time of induction.

show abstract

“…It has been suggested that propofol may affect the potency of neuromuscular blocking drugs. In one study a 20-min infusion of propofol caused a 50% rise in the potency of mivacurium as compared to a 5-min propofol infusion [14]. We used a target controlled infusion of propofol and the target was kept unchanged at 4 μg/ml in each patient during the maintenance of anesthesia for the entire study period.…”

Section: Discussionmentioning

confidence: 99%

Effect of nitrous oxide on cisatracurium infusion demands: a randomized controlled trial

2010

View full text Add to dashboard Cite

BackgroundRecent studies have questioned our previous understanding on the effect of nitrous oxide on muscle relaxants, since nitrous oxide has been shown to potentiate the action of bolus doses of mivacurium, rocuronium and vecuronium. This study was aimed to investigate the possible effect of nitrous oxide on the infusion requirements of cisatracurium.Methods70 ASA physical status I-III patients aged 18-75 years were enrolled in this randomized trial. The patients were undergoing elective surgery requiring general anesthesia with a duration of at least 90 minutes. Patients were randomized to receive propofol and remifentanil by target controlled infusion in combination with either a mixture of oxygen and nitrous oxide (Nitrous oxide/TIVA group) or oxygen in air (Air/TIVA group). A 0.1 mg/kg initial bolus of cisatracurium was administered before tracheal intubation, followed by a closed-loop computer controlled infusion of cisatracurium to produce and maintain a 90% neuromuscular block. Cumulative dose requirements of cisatracurium during the 90-min study period after bolus administration were measured and the asymptotic steady state rate of infusion to produce a constant 90% block was determined by applying nonlinear curve fitting to the data on the cumulative dose requirement during the study period.ResultsController performance, i.e. the ability of the controller to maintain neuromuscular block constant at the setpoint and patient characteristics were similar in both groups. The administration of nitrous oxide did not affect cisatracurium infusion requirements. The mean steady-state rates of infusion were 0.072 +/- 0.018 and 0.066 +/- 0.017 mg * kg-1 * h-1 in Air/TIVA and Nitrous oxide/TIVA groups, respectively.ConclusionsNitrous oxide does not affect the infusion requirements of cisatracurium.Trial registrationClinicalTrials.gov NCT01152905; European Clinical Trials Database at http://eudract.emea.eu.int/2006-006037-41.

show abstract

L’anesthésie intraveineuse totale avec le propofol augmente la puissance du mivacurium

Cited by 8 publications

References 29 publications

Clinical evaluation of a simultaneous closed-loop anaesthesia control system for depth of anaesthesia and neuromuscular blockade*

Clinical evaluation of a simultaneous closed-loop anaesthesia control system for depth of anaesthesia and neuromuscular blockade*

Effects of single‐shot and steady‐state propofol anaesthesia on rocuronium dose–response relationship: a randomised trial

Effect of nitrous oxide on cisatracurium infusion demands: a randomized controlled trial

Contact Info

Product

Resources

About