The reversal of profound mivacurium-induced neuromuscular blockade

Kao, Y. J.; Le, Nhat D.

doi:10.1007/bf03011839

Cited by 13 publications

(19 citation statements)

References 23 publications

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“…In other studies, [17][18][19][20] 0.1-1.0 mg·kg -1 edrophonium, administered after recovery at the AP to 10% of baseline or less, shortened recovery to a TOF ratio $ 0.7 by approximately four to eight minutes. However, even this degree of shortening of recovery is not observed when antagonism is attempted at nearly complete block (1% of control).…”

Section: Méthodementioning

confidence: 82%

Edrophonium effectively antagonizes neuromuscular block at the laryngeal adductors induced by rapacuronium, rocuronium and cisatracurium, but not mivacurium

Suzuki

Lien

Belmont

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To examine the efficacy of antagonism of rapacuronium-, mivacurium-, rocuronium-and cisatracurium-induced neuromuscular block at the laryngeal adductors (LA). M Me et th ho od ds s: :One hundred four patients were randomly assigned to one of eight study groups. They either received rapacuronium 1.5 mg·kg ) at 10% recovery of the first twitch (T1) of train-of-four (TOF) at the LA or were allowed to recover spontaneously from neuromuscular block. The effect of antagonism on speed of recovery of neuromuscular function at the LA was evaluated.R Re es su ul lt ts s: : The time to recovery to a TOF ratio of 0.9 at the LA, when compared to the spontaneous recovery group, was significantly shortened by the administration of edrophonium in patients receiving rapacuronium [19.2 ± 7.8 vs 26.2 ± 4.9 (mean ± SD) min], rocuronium (24.7 ± 14.3 vs 44.4 ± 13.0 min) and cisatracurium (24.2 ± 5.7 vs 35.1 ± 7.6 min). Edrophonium administration did not shorten complete recovery from mivacurium-induced block (15.7 ± 8.0 vs 17.6 ± 6.1 min).C Co on nc cl lu us si io on n: : Recovery from rapacuronium-, rocuronium-or cisatracurium-induced neuromuscular block to a TOF ratio of 0.9 as measured at the LA was shortened by the administration of edrophonium, when compared to spontaneous recovery. [19,2 ± 7,8 vs 26,2 ± 4,9 (moyenne ± écart type) min], le rocuronium (24,7 ± 14,3 vs 44,4 ± 13,0 min) et le cisatracurium (24,2 ± 5,7 vs 35,1 ± 7,6 min). L'administration d'édrophonium n'a pas raccourci le temps de récupération complète d'un bloc induit par le mivacurium (15,7 ± 8,0 vs 17,6 ± 6,1 min Objectif

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Section: Méthodementioning

confidence: 82%

Edrophonium effectively antagonizes neuromuscular block at the laryngeal adductors induced by rapacuronium, rocuronium and cisatracurium, but not mivacurium

Suzuki

Lien

Belmont

et al. 2003

Can J Anesth/J Can Anesth

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“…Sixteen randomized controlled studies with data from 546 patients were included . Six studies compared spontaneous recovery with both neostigmine and edrophonium reversal .…”

Section: Resultsmentioning

confidence: 99%

“…Sixteen randomized controlled studies with data from 546 patients were included . Six studies compared spontaneous recovery with both neostigmine and edrophonium reversal . Five studies compared spontaneous recovery with neostigmine reversal and five studies compared spontaneous recovery with edrophonium reversal No studies on pyridostigmine were included.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 11 studies compared spontaneous recovery with one or more group(s) receiving neostigmine . Study characteristics, results and quality assessment are listed in Table .…”

Section: Resultsmentioning

confidence: 99%

“…The studies were heterogenic eg administration time of cholinesterase inhibitor, definition of endpoint (recovery as TOF ratio between 0.7 and 0.95), type of anaesthetics and doses of neostigmine. Two studies used our predefined endpoint TOF 0.9 . These studies also presented time to TOF 0.7.…”

Section: Resultsmentioning

confidence: 99%

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

Brinch

Söderström

Gätke

et al. 2018

Acta Anaesthesiol Scand

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Background: Mivacurium is a short-acting non-depolarizing muscle relaxant, which is hydrolyzed by butyrylcholinesterase. The neuromuscular block (NMB) can be antagonized with cholinesterase inhibitors (CHEI), but the short duration of action of mivacurium questions the need. This systematic review evaluated if the use of CHEIs (neostigmine, pyridostigmine or edrophonium) facilitates reversal of mivacurium-induced NMB. Method:Randomized controlled trials and crossover-studies comparing spontaneous recovery with CHEI reversal in patients with mivacurium-induced NMB, assessed with quantitative neuromuscular monitoring, were included. Mean time from injection of the CHEI or allowing of spontaneous recovery to an endpoint representing full recovery was used as outcome. First response to train-of-four nerve stimulation (T 1 ) described the level of NMB for administration of the CHEI. Moderate NMB refers to T 1 ≥ 5% and deeper NMB refers to T 1 < 5%. Systematic critical appraisal was performed using the Scottish Intercollegiate Guidelines Network guidelines.Overall quality assessment was done using the Grading of Recommendations Assessment, Development and Evaluation approach.Results: Sixteen studies with data from 546 patients were included. Low quality of evidence was found that neostigmine and edrophonium administered at moderate NMB accelerated recovery with up to approximately 5.5-6.5 and 6.5-9.0 minutes, respectively. At deeper NMB only edrophonium accelerated recovery. The effect of neostigmine was not clarified at deeper mivacurium-induced NMB. No studies with reversal by pyridostigmine were identified.Conclusion: Low quality of evidence supports that neostigmine and edrophonium accelerate the recovery of mivacurium-induced NMB with 5-6.5 and 6-9.0 minutes respectively, when administered at moderate NMB. At deeper NMB only edrophonium accelerated the recovery.

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Advances in Clinical Pharmacology of the Muscle Relaxants

Melloni¹

2001

Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.

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The reversal of profound mivacurium-induced neuromuscular blockade

Cited by 13 publications

References 23 publications

Edrophonium effectively antagonizes neuromuscular block at the laryngeal adductors induced by rapacuronium, rocuronium and cisatracurium, but not mivacurium

Edrophonium effectively antagonizes neuromuscular block at the laryngeal adductors induced by rapacuronium, rocuronium and cisatracurium, but not mivacurium

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

Advances in Clinical Pharmacology of the Muscle Relaxants

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