Department of Anesthesiology

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Neuromuscular and cardiovascular effects of mivacurium in children.

TitleNeuromuscular and cardiovascular effects of mivacurium in children.
Publication TypeJournal Article
Year of Publication1989
AuthorsGoudsouzian NG, Alifimoff JK, Eberly C, Smeets R, Griswold J, Miler V, McNulty BF, Savarese JJ
JournalAnesthesiology
Volume70
Issue2
Pagination237-42
Date Published1989 Feb
ISSN0003-3022
KeywordsAnesthesia, Cardiovascular System, Child, Child, Preschool, Fentanyl, Halothane, Hemodynamics, Humans, Isoquinolines, Morphine, Neuromuscular Junction, Neuromuscular Nondepolarizing Agents, Nitrous Oxide, Oxygen
Abstract

The neuromuscular and cardiovascular effects of mivacurium chloride (BW B1090U) were evaluated in 90 children (2-12 yr) during N2O:O2 halothane or N2O:O2 narcotic anesthesia. Neuromuscular response was evaluated by recording the force of contraction of the adductor of the thumb during train-of-four stimulation at 0.1 Hz. The children were divided into two groups. Patients in group A (n = 45) were anesthetized with N2O:O2 and halothane (1% inspired) and patients in group B (n = 45) were anesthetized with N2O:O2 and fentanyl or morphine. Each group was further divided into five subgroups of nine children. Children in the first three sets of subgroups (A1-A3, B1-B3) received an initial dose of 0.02, 0.04, 0.05, 0.06 or 0.07 mg/kg mivacurium to determine dose response relationships under the different anesthetic regimens. The ED50 and ED95 neuromuscular blocking doses calculated from this single dose technique were 0.051 mg/kg and 0.095 mg/kg, respectively, in children anesthetized with halothane N2O:O2, and 0.059 mg/kg and 0.11 mg/kg in children anesthetized with N2O:O2 narcotic. The fourth subset of each group (A4 and B4) received 0.09 mg/kg and 0.11 mg/kg mivacurium, the estimated ED95 for each respectively. The last subsets (A5 and B5) received 0.2 mg/kg. This dose induced 100% depression of the twitch response in all 18 patients in 1.8 +/- 0.1 min, with recovery to 5%, 25%, and 95% of control occurring in 8.4 +/- 0.5, 11.2 +/- 0.6 and 18.4 +/- 1.6 min, respectively. The recovery indices for all patients were 4.6 +/- 0.6 min for 25-75% recovery and 9.7 +/- 1.3 min for 5-95% recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

Alternate JournalAnesthesiology
PubMed ID2521550