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British Journal of Anaesthesia, 1988, Vol. 61, No. 5 541-546
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

CLINICAL PHARMACOLOGY OF MIVACURIUM CHLORIDE (BW B1090U) INFUSION: COMPARISON WITH VECURONIUM AND ATRACURIUM{dagger}

H. H. ALI, M.D., J. J. SAVARESE, M.D., P. B. EMBREE, C.R.N.A., S. J. BASTA, M.D., R. G. STOUT, B.S., L. H. BOTTROS, M.D. and J. N. WEAKLY, PH.D.

Anesthesia Laboratories, Department of Anesthesia, Harvard Medical School at Massachusetts General Hospital 32 Fruit Street, Boston, Ma 02114, U.S.A.
Department of Neurosciences, Division of Clinical Research, Burroughs Wellcome Company, Research Triangle Park NC 27709, U.S.A.

Correspondence to H.H.A.

Mivacurium chloride (BWB1090U) is a new, short-acting non-depolarizing neuromuscular blocking agent. It is a synthetic bis-benzylisoquinolinium diester, which is hydrolysed rapidly by plasma cholinesterase. This study compares mivacurium, atracurium and vecuronium by continuous i.v. infusion. The duration of mivacurium infusion ranged from 29.5 to 286 min. The steady state infusion rates necessary to maintain 95 (SEM 4)% twitch suppression were: mivacurium 8.3 (0.7) µg kg–1 min–1; atracurium 7.9 (0.4) µg kg–1 min–1; vecuronium 1.2 (0.3) µg kg–1 min–1. Following infusions of mivacurium, various recovery times (for example: 25–75%, 6.9 (0.3) min; 25–95%, 11.0 (0.4) min; 5–95% 14.5 (0.4) min) did not differ significantly from those following single bolus doses. Recovery times following cessation of mivacarium infusions were approximately 50% of those for equivalent durations of infusion of atracurium (10.9 (0.3) min for 25–75% recovery and 26.6 (0.4) min for 5–95% recovery). For vecuronium, corresponding recovery times were 13.8 (0.9) and 32.0 (1.2) min, respectively. Comparative recovery times for mivacurium were 40–50% of those for vecuronium. There was a significant correlation between the infusion rate of mivacurium required to maintain 95% twitch depression and the plasma cholinesterase activity of individual subjects.

{dagger}Presented in part in Abstract form at the Annual Meeting, American Society of Anesthesiologist, Las Vegas, Nevada, 1986.


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