Mivacurium Infusion Requirements in Pediatric Surgical Patients During Nitrous Oxide-Halothane and During Nitrous Oxide-Narcotic Anesthesia

Brandom, Barbara W.; Sarner, J. B.; Woelfel, S. K.; Dong, Mai-Li; Horn, Michael; Borland, Lawrence M.; Cook, David; Foster, Vicki J.; McNulty, Barbara; Weakly, J. N.

doi:10.1213/00000539-199007000-00003

Cited by 53 publications

(18 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although a control group is not present in our group of patients, there is a tendency to decreased infusion requirements in patients with DMD when compared to normal children (Alifimoff & Goudsouzian 1989;Brandom, .Sarner & Woelfel 1990). The infusion requirements did not seem to correlate with our preoperative assessment of the patient's physical status and strength.…”

Section: Discussionmentioning

confidence: 61%

Mivacurium in children with Duchenne muscular dystrophy

Tobias

Atwood

1994

Pediatric Anesthesia

View full text Add to dashboard Cite

The authors retrospectively reviewed their experience with mivacurium for neuromuscular blockade in seven children with Duchenne muscular dystrophy. Mivacurium was administered to seven children ranging in age from 8.3 to 14.4 years and in weight from 29 kg to 68 kg during either posterior spinal fusion or lower extremity release. An initial bolus dose of 0.2 mgkg-' was followed by a continuous infusion. Neuromuscular blockade was monitored with a standard twitch monitor and the TOF (2 Hz for 2 s). Complete suppression of all four twitches occurred in 1.5 to 2.6 min. The continuous infusion was started with the return of the first twitch and adjusted to maintain one twitch. Time to recovery of the first twitch varied from 12 to 18 min. Continuous infusion requirements varied from 3 to 20 Fgkg-' with an average for the case of less than 10 pg-kg-' min-' in five of the seven patients. A moderate increase in sensitivity to mivacurium in this patient population is suggested by a decrease in infusion requirements and a prolonged effect following the initial dose.

show abstract

Section: Discussionmentioning

confidence: 61%

Mivacurium in children with Duchenne muscular dystrophy

Tobias

Atwood

1994

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…The ED95 in children during halothane anaesthesia is approximately 0.1 mg-kg-l. Twice this dose (0.2 mg-kg-') will produce complete twitch suppression in 1.8 min with recovery to 25 and 95% of control in 11 and 19 min respectively. The recovery index (2575%) is 4 min (Goudsouzian et al 198913;Brandom et al 1990). The short duration of action is partly attributed to its hydrolysis by plasma cholinesterase, although this is not the only degradation pathway.…”

Section: Mivacuriummentioning

confidence: 99%

“…A most interesting observation in this regard is that the recovery of the twitch response is virtually the same following either a single bolus dose or a lengthy infusion. Children recover from 595% of control twitch in about 15 min, irrespective of the dose or mode of administration (Alifimoff & Goudsouzian 1989;Brandom et al 1990).…”

Section: Mivacuriummentioning

confidence: 99%

Neuromuscular blocking agents in children

Goudsouzian¹

1991

Pediatric Anesthesia

View full text Add to dashboard Cite

This article will review the pharmacology of muscle relaxants in children. The neuromuscular pharmacology of the very young (infants less than one year) will be discussed in the next issue of the Journal. In this review the neuromuscular blocking drugs will be discussed in the order of their duration of action. Swamethonium and the recently developed shortacting mivacurium will be considered, followed by the two intermediate-acting agents vecuronium and atracurium (see Figure 1). The last group to be discussed will be the long-acting compounds (pancuronium, tubocurarine, metocurine, alcuronium, gallamine, doxacurium and pipecuronium) (see Figure 2 and Table 1). SuxamethoniumSwamethonium (succinyldicholine) is still the shortest acting neuromuscular blocking agent and the only depolarizing compound regularly used in children. Determinations of effective doses have shown that the ED95 in children less than 10 years of age is 0.42-0.45 mgkg-'; in older children (more than 11 years) the ED95 is 0.27 mg-kg-' a value comparable to that in adults (ED95 0.29 mgkg-') (Meakin et al.

show abstract

“…On the basis of the known pharmacokinetic information of the isomers of mivacurium, there is the possibility of accumulation of the cis-cis isomer (t l/2 =55 min versus 2 min for cis-trans and trans-trans) [3] which could lead to residual blockade. The transtrans and cis-trans isomers possess similar neuromuscular blocking potencies [8][9][10]. The neuromuscular blocking potency of the cis-cis isomer has not been established in humans, but data suggests that this isomer produces minimal (less than 5%) block [3].…”

Section: Introductionmentioning

confidence: 99%