Mivacurium infusion during nitrous oxide—Isoflurane anesthesia: A comparison with nitrous oxide-opioid anesthesia

The effect of halothane on mivacurium infusion requirements in adult surgical patients

“…The interaction between neuromuscular blocking drugs and volatile anaesthetics depends also on the inhalational anaesthetic. Isoflurane and enflurane have been shown to potentiate the effect of mivacurium (3)(4)(5)(6)(7)(8). Halothane has the weakest potentiating effect on muscle relaxants.…”

Reversal of mivacurium‐induced neuromuscular blockade with a cholinesterase inhibitor: A systematic review

“…This heterogeneity probably explains a major part of the variability in effect found throughout the studies. For example, seven studies used inhalation agents which is known to decrease mivacurium requirements . Also the time for administration varied from first detection of muscle contraction in response to PTC up to T 1 = 25%.…”

Mivacurium infusion requirement and spontaneous recovery of neuromuscular transmission in children anaesthetized with nitrous oxide and fentanyl, halothane, isoflurane or sevoflurane

“…One of them is age. In adults anaesthetized with N 2 O and fentanyl, the mean infusion rate required to maintain 95% depression of T 1 was 5.3–8.3 μg·kg –1 ·min –1 (3,6,7,16,17,19,30–32), and individual values varied widely in the range from 2 μg·kg –1 ·min –1 (6) to 20.4 μg·kg –1 ·min –1 (3). The mean infusion rate in children was much higher than in adults, ranging from 13 to 16 μg·kg –1 ·min –1 (12,19,31,33–35).…”

“…Nevertheless, from a practical point of view, the delay in the recovery of the neuromuscular transmission was of little importance. Some researchers found that inhalational anaesthetics did not affect recovery of the neuromucular transmission at all (12,17). In our study, inhalational anaesthetics prolonged the mean time from T 1 =10% to TOF=70% from 8.7 to 11.1 min, a difference of no clinical significance, and the time when the first twitch could be detected by touch or sight to the time when the tracheal tube could be safely removed never took longer than 16.5 min, even in the presence of inhalational anaesthetics.…”

“…Halothane (11–16), enflurane (7,14), isoflurane (14–20), sevoflurane (19–21) and desflurane (5,21) potentiate the neuromuscular block produced by mivacurium and, therefore, the infusion rate required to maintain a stable block of neuromuscular transmission depends on the drugs used for anaesthesia.…”