Mivacurium or vecuronium for muscular relaxation in day-case surgery

Rigg, J. D.; Wilson, A.; Pollard, B. J.

doi:10.1097/00003643-199711000-00012

Cited by 1 publication

(3 citation statements)

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“…Several studies reported that the patient's plasma cholinesterase activity has a significant negative correlation with recovery indices after mivacurium in healthy patients or hepatic cirrhosis [3][4][5][6]21], but not in earlier studies of the neuromuscular blockade given to healthy subjects [1,2]. This discrepancy may result from differences in the methods used to assay plasma cholinesterase.…”

Section: Groupmentioning

confidence: 99%

“…The short duration of action of mivacurium is in large part related to its hydrolysis by plasma cholinesterase [1,2]. Patients with liver failure exhibited markedly reduced plasma cholinesterase activity, which produced prolonged recovery of neuromuscular blockade [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with liver failure exhibited markedly reduced plasma cholinesterase activity, which produced prolonged recovery of neuromuscular blockade [3,4]. Several earlier studies demonstrated a negative correlation between plasma cholinesterase activity and duration of neuromuscular block in healthy patients [5,6] and those with hepatic failure [3,4], and also reported conflicting results in healthy subjects [1,2]. However, the small number of patients included in human studies with hepatic failure does not permit us to draw conclusions about mivacurium.…”

Section: Introductionmentioning

confidence: 99%

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The pharmacodynamics of mivacurium in the rabbit with carbon tetrachloride-induced liver disease

Cheong

Kim

Lee

2007

European Journal of Anaesthesiology

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Background and objective: Neuromuscular blocking effects according to the severity of liver dysfunction have not been evaluated. We assessed the neuromuscular effects of mivacurium in carbon tetrachloride (CCl 4 )-treated rabbits with toxic hepatitis in vivo. Methods: We compared the dose-response relationships and the neuromuscular blocking effects of mivacurium in 66 rabbits randomly treated with 0.3 mL kg 21 of corn oil, 0.3 mL kg 21 of CCl 4 or 0.6 mL kg 21 of CCl 4 for 11 weeks, respectively. Train-of-four stimuli were applied every 10 s to the common peroneal nerve and the force of contraction of the tibialis anterior muscle was measured. Results: Severe hepatitis was associated with a rightward shift of the mivacurium dose-response curves, but mild hepatitis had no effect. The calculated ED 50 values for the control, mild and severe hepatitis were 17.1 6 2.6, 18.2 6 2.7 and 31.8 6 3.2 mg kg 21 , respectively. Rabbits with severe hepatitis had a significantly prolonged recovery time from neuromuscular blockade compared with other rabbits. Cholinesterase activity had a negative correlation with recovery indices of mivacurium even in severe hepatic injury. Severe hepatitis induced a prolongation of action duration of repeated doses, but maintained the constant intervals. Conclusions: The dose-response and the time course of neuromuscular blockade of mivacurium differ in mild hepatitis compared with severe hepatitis, but required no adjustments of different doses for repeated injection after the desired depth of neuromuscular block, and had a negative correlation with the activity of plasma cholinesterase in both hepatic injuries.

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