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British Journal of Anaesthesia, Vol 78, Issue 2 222-223, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia

SHORT COMMUNICATIONS

Low-dose mivacurium supplementation of prilocaine i.v. regional anaesthesia

J. M. Torrance, BMF. Lewer and D. C. Galletly
Section of Anaesthesia, Wellington School of Medicine, Private Bag, Wellington, New Zealand

We have compared in two groups of five healthy volunteers, the motor effect of prilocaine i.v. regional anaesthesia of the forearm with and without addition of mivacurium 0.6 mg. Although addition of mivacurium might, theoretically, provide the benefit of increased neuromuscular block with rapid plasma cholinesterase degradation in the isolated limb, we observed prolonged forearm weakness in the mivacurium group using tests of grip strength (median recovery to 90% of control, 80 min (range 60 min to > 8 h) vs control median recovery to 90% of 16 (8-24) min) and bead transfer (median recovery to 90% of control 36 (24-48) min vs control median recovery to 90% of 12 (8-16) min). This weakness was considerably in excess of that predicted by rapid systemic degradation of mivacurium. The mivacurium group experienced symptoms of local anaesthetic toxicity which did not occur in the control group and which could not be replicated by administration of mivacurium alone.
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