Plasma cholinesterase activity and duration of action of mivacurium in phenotypically normal patients

Østergaard, Doris; Ibsen, M.; Skovgaard, L. T.; Viby‐Mogensen, J.

doi:10.1034/j.1399-6576.2002.460608.x

Cited by 11 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The duration of action exhibits a weak inverse relationship with BChE activity, at least in phenotypically normal subjects (Ostergaard et al, 2002). In BCHE genotypes associated with severe deficiency (e.g., AA and SS), paralysis lasts up to 6 to 8 h (Rosenberg and Lebenborn-Mansour, 1997;Gatke et al, 2001).…”

Section: B Butyrylcholinesterasementioning

confidence: 99%

Pharmacogenetics, Drug-Metabolizing Enzymes, and Clinical Practice

2006

View full text Add to dashboard Cite

Section: B Butyrylcholinesterasementioning

confidence: 99%

Pharmacogenetics, Drug-Metabolizing Enzymes, and Clinical Practice

2006

View full text Add to dashboard Cite

“…Variations in butyrylcholinesterase activity would contribute to variation in the speed and magnitude of neuromuscular block after mivacurium. However, as with suxamethonium , butyrylcholinesterase activity needs to be significantly reduced before any increase in the effect of mivacurium can be demonstrated . The ease with which intubation of the trachea can be accomplished depends upon the interplay of neuromuscular blockade, depth of anaesthesia and technical proficiency: deficiency in one can be compensated for by another .…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-regression analysis of mivacurium for tracheal intubation

et al. 2014

View full text Add to dashboard Cite

SummaryWe systematically reviewed factors associated with intubation conditions in randomised controlled trials of mivacurium, using random-effects meta-regression analysis. We included 29 studies of 1050 healthy participants. Four factors explained 72.9% of the variation in the probability of excellent intubation conditions: mivacurium dose, 24.4%; opioid use, 29.9%; time to intubation and age together, 18.6%. The odds ratio (95% CI) for excellent intubation was 3.14 (1.65-5.73) for doubling the mivacurium dose, 5.99 (2.14-15.18) for adding opioids to the intubation sequence, and 6.55 (6.01-7.74) for increasing the delay between mivacurium injection and airway insertion from 1 to 2 min in subjects aged 25 years and 2.17 (2.01-2.69) for subjects aged 70 years, p < 0.001 for all. We conclude that good conditions for tracheal intubation are more likely by delaying laryngoscopy after injecting a higher dose of mivacurium with an opioid, particularly in older people.

show abstract

“…The management of a patient with a prolonged response to mivacurium should be conservative and expectant, as for suxamethonium. The patient should be kept anaesthetised and their lungs ventilated until the TOF ratio is ≥ 0.9 [106–108]. Unless human cholinesterase (which is rarely available) is injected before neostigmine, the effect of the neostigmine is unpredictable and may intensify rather than antagonise the block [108].…”

Section: Non‐depolarising Neuromuscular Blocking Drugsmentioning

confidence: 99%

The undesirable effects of neuromuscular blocking drugs

Claudius¹,

Garvey

Viby‐Mogensen

2009

Anaesthesia

Self Cite

View full text Add to dashboard Cite

SummaryNeuromuscular blocking drugs are designed to bind to the nicotinic receptor at the neuromuscular junction. However, they also interact with other acetylcholine receptors in the body. Binding to these receptors causes adverse effects that vary with the specificity for the cholinergic receptor in question. Moreover, all neuromuscular blocking drugs may cause hypersensitivity reactions. Often the symptoms are mild and self-limiting but massive histamine release can cause systematic reactions with circulatory and respiratory symptoms and signs. At the end of anaesthesia, no residual effect of a neuromuscular blocking drug should be present. However, the huge variability in response to neuromuscular blocking drugs makes it impossible to predict which patient will suffer postoperative residual curarization. This article discusses the undesirable effects of the currently available neuromuscular blocking drugs including the definitions, diagnosis and causes of hypersensitivity reactions and postoperative residual curarisation.

show abstract

Plasma cholinesterase activity and duration of action of mivacurium in phenotypically normal patients

Cited by 11 publications

References 13 publications

Pharmacogenetics, Drug-Metabolizing Enzymes, and Clinical Practice

Pharmacogenetics, Drug-Metabolizing Enzymes, and Clinical Practice

A systematic review and meta-regression analysis of mivacurium for tracheal intubation

The undesirable effects of neuromuscular blocking drugs

Contact Info

Product

Resources

About