The influence of isoflurane on a continuous infusion of mivacurium

Mey, J. C. De; Fonck, Kristine; Mareels, K; Rolly, G

doi:10.1111/j.1365-2044.1995.tb05925.x

Cited by 7 publications

(3 citation statements)

References 6 publications

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“…from late pregnancy into the early postpartum period. When the duration of action of mivacurium and the average infusion rate demonstrated in this study were compared with studies in non-pregnant normal adults, results were similar in two recent studies 15,16 but mivacurium requirement was significantly less in three other studies 3,4,18 . The different anaesthetic techniques employed may have contributed to these differences.…”

Section: Discussionsupporting

confidence: 75%

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Recovery from Mivacurium Block with or without Anticholinesterase following Continuous Infusion in Obstetric Patients

Jan

Tong

Chan

et al. 1996

Anaesth Intensive Care

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Neostigmine antagonism after suxamethonium followed by mivacurium chloride bolus and infusion was studied. Thirty ASA group I or II patients were given mivacurium 0.15 mg/kg followed by infusion during nitrous oxide-enflurane-pethidine anaesthesia. Train of four (TOF) stimuli were applied to the ulnar nerve at the wrist and TOF twitch height and ratio measured by TOF-GUARD nerve stimulator. Mivacurium infusion was titrated to give a 90% block of first twitch height. Patients were randomized into two groups. Group I patients recovered from the mivacurium block spontaneously while Group II patients were given neostigmine 0.05 mg/kg and atropine 0.02 mg/kg. Time to reach train of four ratio (TOFR) of 25%, 50% and 70% were measured. This study demonstrated a mean infusion rate of 5.1±1.8 µg/kg/min to maintain a 90% neuromuscular block. In the spontaneous recovery group, time to reach TOFR of 25%, 50% and 70% were 9.3±2.7 min, 13.5±3.0 min and 16.7±3.0 min respectively while the corresponding times in the neostigmine group were 5.2±1.7 min, 10.9±2.2 min and 16.1±7.4 min respectively. There were significant differences in the time taken to TOFR of 25% (P<0.0001) and 50% (P<0.05) but no difference in the time taken for TOFR to return to 70%. We concluded that mivacurium is suitable for use in caesarean section despite a decrease in plasma cholinesterase activity. Neostigmine antagonism is not required as a routine.

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Section: Discussionsupporting

confidence: 75%

“…It has been shown that volatile agents such as enflurane 18 , isoflurane 16 and nitrous oxide but not halothane 19 potentiate the effects of mivacurium in normal adults. To prevent patients' awareness before regaining adequate muscle power, in our study enflurane was continued after the operation ended until the TOFR returned to 70%.…”

Section: Discussionmentioning

confidence: 99%

Recovery from Mivacurium Block with or without Anticholinesterase following Continuous Infusion in Obstetric Patients

Jan

Tong

Chan

et al. 1996

Anaesth Intensive Care

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“…8 In one study, isoflurane did not alter mivacurium infusion rates compared with propofol. 9 One possible explanation is that potentiation with volatile agents takes time to develop, because of the time taken for equilibrium of the agent with muscle tissue. 10 Sevoflurane has been reported to potentiate blockade produced by mivacurium, 11 rocuronium, 5,7 vecuronium, 12 and cisatracurium, 4 but the effect is not always consistent.…”

Section: Méthode : Chez 48 Patients Consentants Classifiés Asa I Ou mentioning

confidence: 99%

Sevoflurane and isoflurane, but not propofol, decrease mivacurium requirements over time

Motamed

Donati

2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Volatile anesthetic agents potentiate neuromuscular blockade, but the magnitude of potentiation appears to be time dependent. The time course of this interaction was studied by measuring mivacurium infusion rates during sevoflurane, isoflurane and propofol anesthesia.M Me et th ho od ds s: : After informed consent, anesthesia was induced in 48 ASA physical status I-II adults with propofol, fentanyl and mivacurium 0.25 mg·kg -1 and maintained with N 2 O (60%) and one of the three agents chosen at random: sevoflurane 1.9%; isoflurane 1.2%; or propofol 100-150 µg·kg -1 ·min -1 . Train-of-four stimulation was applied every 15 sec to the ulnar nerve. Neuromuscular blockade was monitored with accelerometry. At 5% recovery of the first twitch (T1), a mivacurium infusion was started and adjusted every five minutes to maintain 90-95% T1 depression.R Re es su ul lt ts s: : The time to 5% T1 recovery after the initial dose was similar in all groups (13-15 min). Fifteen minutes after the start of the infusion mivacurium requirements were greater (P < 0.05) in the propofol group (7.5 ± 1.7 µg·kg -1 ·min -1 ; mean ± SD) than in either isoflurane (4.7 ± 1.6 µg·kg -1 ·min -1 ) or sevoflurane (4.5 ± 1.5 µg·kg -1 ·min -1 ) group. Then, the rate remained stable for propofol (6.2 ± 1.4 µg·kg -1 ·min -1 after 90 min of infusion) while it decreased with isoflurane to 2.9 ± 1.6 µg·kg -1 ·min -1 at 90 min (P < 0.05 vs propofol) and to 1.4 ± 1.0 µg·kg -1 ·min -1 in the sevoflurane group (P < 0.05 vs propofol and isoflurane).

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Potency and time course of mivacurium block during sevoflurane, isoflurane and intravenous anesthesia

Lowry

Mirakhur

Carroll

et al. 1999

Can J Anesth/J Can Anesth

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The influence of isoflurane on a continuous infusion of mivacurium

Cited by 7 publications

References 6 publications

Recovery from Mivacurium Block with or without Anticholinesterase following Continuous Infusion in Obstetric Patients

Recovery from Mivacurium Block with or without Anticholinesterase following Continuous Infusion in Obstetric Patients

Sevoflurane and isoflurane, but not propofol, decrease mivacurium requirements over time

Potency and time course of mivacurium block during sevoflurane, isoflurane and intravenous anesthesia

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