Onset and duration of mivacurium‐induced neuromuscular blockade in children with Charcot–Marie–Tooth disease. A case series with five children

Hj, Schmitt; Wick, S.; Münster, Tino

doi:10.1111/j.1460-9592.2005.01627.x

Cited by 13 publications

(9 citation statements)

References 22 publications

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“…These data are consistent with a recent investigation in five children where a normal response to mivacurium was observed. 12 These findings are difficult to compare with historical data, as assessment of neuromuscular function during anesthesia has been inconsistently documented in patients with CMT disease. [3][4][5][6][7] The reported duration of NMB ranges from normal to very prolonged following administration of different nondepolarizing NMBDs.…”

Section: Discussionmentioning

confidence: 99%

Mivacurium-induced neuromuscular block in adult patients suffering from Charcot-Marie-Tooth disease

Münster

2006

Can J Anesth/J Can Anesth

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Purpose:The response to non-depolarizing neuromuscular blocking drugs is variable in patients with Charcot-Marie-Tooth (CMT) disease. We speculated that CMT involvement of the monitored muscle may be partially responsible for this inconsistency. We therefore investigated the response to a standard dose of mivacurium simultaneously assessed at adductor pollicis (AP) and orbicularis oculi (OO) muscles in five patients with CMT.Clinical features: Over a period of one year, five adult patients with CMT scheduled for orthopedic surgery were studied. The right arm and the right supercilliary arch were prepared for acceleromyographic (AMG) neuromuscular monitoring. The AMG probes were attached at the distal interphalangeal joint of the right thumb and on the right upper eyelid to record the response of the AP and OO, respectively. The ulnar nerve and upper part of the facial nerve were stimulated supramaximally with repeated train-of-four stimuli (2 Hz, 0.2 msec) every 15 sec via applied surface electrodes. Following monitor calibration and induction of general anesthesia, mivacurium 0.2 mg·kg -1 iv was given, and the time course of relaxation and recovery were assessed. Times to spontaneous recovery of T1 to 25% were 15 ± 3 vs 12 ± 4 min in the AP and OO muscle groups respectively, whereas times to 90% recovery were 23 ± 5 vs 29 ± 10 min, respectively. Conclusion: The onset and recovery characteristics associated with mivacurium-induced neuromuscular block were similar at the AP and OO muscle groups. A near normal response to mivacurium was observed in this small series of patients with CMT disease. Objectif : La réaction aux curarisants non dépolarisants varie d'un patient à l'autre dans la maladie de Charcot-Marie-Tooth (CMT). En supposant qu'une atteinte du muscle sous observation et déjà atteint par la maladie MCT était partiellement responsable de cette variation, nous avons vérifié la réponse à une dose habituelle de mivacurium simultanément à l'adducteur du pouce (AP) et au muscle orbiculaire des paupières (OP) chez cinq patients atteints de CMT. Éléments cliniques : Au cours d'une année, cinq patients adultes atteints de CMT et opérés en orthopédie ont été étudiés. Le bras droit et l'arcade sourcilière ont été préparés pour un monitorage de la transmission neuromusculaire accéléromyographique (AMG). Les sondes d'AMG ont été fixées à l'articulation interphalan-

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Section: Discussionmentioning

confidence: 99%

Mivacurium-induced neuromuscular block in adult patients suffering from Charcot-Marie-Tooth disease

Münster

2006

Can J Anesth/J Can Anesth

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“…Data is less clear on the topic of non-depolarizing agents. A small case series using nondepolarizing muscle relaxants found that mivacurium had similar activity in CMT patients when compared to children without neuromuscular disease [13]. However, both normal and prolonged neuromuscular blockade has been reported with vecuronium [14,15].…”

Section: Anesthetic Considerationsmentioning

confidence: 99%

Subarachnoid and Peripheral Nerve Block in a Patient with Charcot-Marie-Tooth Disease

Ritter¹,

Jense²,

Davies³

2013

OJAnes

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Charcot-Marie-Tooth disease (CMT) is a hereditary peripheral neuropathy characterized by progressive distal muscle weakness and wasting. If conservative treatment fails, or is not appropriately initiated, deformity, immobility and chronic pain may result. In severe cases, surgical intervention may be required. With the exception of case reports and case series, limited safety and efficacy data exists regarding the use of neuraxial and regional anesthesia for patients with CMT. This paper describes an anesthetic case report of a patient with CMT, and also provides a review of general and regional anesthetic considerations for this cohort. The purpose of this report is to highlight the potential benefits of neuraxial and regional anesthesia in patients with neuromuscular disorders, especially in settings where intra-and post-operative resources may be limited.

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“…Bei Erkrankungen der Motoneurone wie amyotrophe Lateralsklerose (ALS) und spinale Muskelatrophie (SMA) ist die Gabe von NDMR jedoch mit einer verlängerten Wirkdauer assoziiert und erfordert im Einzelfall eine vorsichtige Titration sowie eine Dosisreduktion [13]. Bei den 7 peripheren Neuropathien wie Charcot-Marie-Tooth-Erkrankung und Friedreich-Ataxie ist eine mit den Normalkollektiven vergleichbare Wirkung beschrieben worden [34,35]. Succinylcholin ist bei präjunk-tionalen Störungen wegen extrajunktionaler Ausbreitung fetaler ACh-Rezeptoren und der hieraus resultierenden schweren Hyperkaliämien kontraindiziert [2].…”

Section: Muskelrelaxanzien Und Neuromuskuläre Erkrankungenunclassified

Neuromuscular monitoring in patients with neuromuscular diseases

2009

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The management of general anaesthesia in patients with neuromuscular disorders remains challenging. The underlying causes and clinical presentations of these rare heterogeneous diseases are highly variable and the only common feature is usually skeletal muscle weakness. The appropriate choice and dosage of muscle relaxants are important and an adequate monitoring of the neuromuscular blockade is obligatory. Neuromuscular monitoring can be complicated because of disease-induced alterations in neurophysiology; however, continuous monitoring of the neuromuscular blockade should be realized to accurately determine the recovery from the blockade. These patients very often have an increased risk for postoperative pulmonary complications, which increases further if a residual neuromuscular blockade is present.

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Onset and duration of mivacurium‐induced neuromuscular blockade in children with Charcot–Marie–Tooth disease. A case series with five children

Abstract: In our small series of patients with CMT the clinical duration of mivacurium-induced neuromuscular block was similar to data known from children without neuromuscular disease.

Cited by 13 publications

References 22 publications

Mivacurium-induced neuromuscular block in adult patients suffering from Charcot-Marie-Tooth disease

Mivacurium-induced neuromuscular block in adult patients suffering from Charcot-Marie-Tooth disease

Subarachnoid and Peripheral Nerve Block in a Patient with Charcot-Marie-Tooth Disease

Neuromuscular monitoring in patients with neuromuscular diseases

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