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British Journal of Anaesthesia, 1989, Vol. 63, No. 4 393-399
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

COMPARISON OF THE NEUROMUSCULAR BLOCK INDUCED BY MIVACURIUM, SUXAMETHONIUM OR ATRACURIUM DURING NITROUS OXIDE-FENTANYL ANAESTHESIA{dagger}

JAMES E. CALDWELL, F.F.A.R.C.S., TOM HEIER, M.D., JOHN B. KITTS, M.D., DANIEL P. LYNAM, M.D., MARK R. FAHEY, M.D. and RONALD D. MILLER, M.D.

Department of Anesthesia, University of California San Francisco 521 Parnassus Avenue, San Francisco, California 94143–0648, U.S.A.

Correspondence to J.E.C.

We compared the neuromuscular and cardiovascular changes following administration of mivacurium 0.15, 0.20 and 0.25 mg kg–1, suxamethonium 1.0 mg kg–1 or atracurium 0.5 mg kg–1 i.v. in 41 (ASA physical status I or II) patients during nitrous oxide—fentanyl anaesthesia. Mean onset times for total ablation of twitch response for mivacurium 0.15, 0.20 and 0.25 mg kg–1, were 2.5, 2.4 and 2.7 min, respectively, similar to that for atracurium (2.5 min), but longer than for suxamethonium (1.1 min) (P < 0.05). Mean times from administration of drug until twitch response recovered to 10% of control were shorter for each dose of mivacurium (15.6, 18.0 and 20.6 min, respectively) than for atracurium (40.0 min) and longer than for suxamethonium (7.7 min) (P < 0.05). Mean infusion rate required to maintain twitch response at 5±4% control was 6.7 µg kg–1 min–1 for mivacurium and 6.3 µg kg–1 min–1 for atracurium. Following neostigmine 0.045 mg kg–1, mean times for twitch tension to recover from 10% to 90% of control were similar for mivacurium (9.7 min) and atracurium (10.5 min). Transient decreases in mean arterial pressure (> 20%) were observed in seven of 15 patients who received the two higher doses of mivacurium.

{dagger} Presented in part at the Annual Scientific Meeting of the American Society of Anesthesiologists, San Francisco, October 1988.


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