British Journal of Anaesthesia, Vol 79, Issue 1 19-23, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia
K. S. Kim, J. C. Shim and D. W. Kim
We have compared the dose-response relationships of mivacurium, pancuronium
and their combination, and examined the interactions by isobolographic and
fractional analyses. We studied 70 adult patients during nitrous
oxide-fentanyl-propofol anaesthesia. The dose-response curves were
determined by probit analysis. The ED95 and ED50 values for mivacurium were
84.2 (95% confidence interval 80.2-88.1) micrograms kg- 1 and 46.2
(40.2-52.1) micrograms kg-1, respectively. Corresponding values for
pancuronium were 68.5 (63.7-73.2) micrograms kg-1 and 40.7 (35.5-45.9)
micrograms kg-1, respectively. Isobolographic and fractional analyses of
the mivacurium-pancuronium combination demonstrated a synergistic
interaction. An additional 30 patients were allocated randomly to receive
either mivacurium 84.2 micrograms kg-1 (n = 15) or pancuronium 68.5
micrograms kg-1 (n = 15). When the first twitch (T1) of TOF recovered to
25%, each patient received mivacurium 46.2 micrograms kg-1. The times after
administration of mivacurium until T1 25% in the mivacurium-pancuronium
group were 6.4 (3.5-9.4) min and 49.8 (44.7-54.9) min, respectively (P <
0.0001). We conclude that the combination of mivacurium and pancuronium was
synergistic and after pancuronium-induced neuromuscular block, mivacurium
became a longer acting agent than the shorter agent.
CLINICAL INVESTIGATIONS
Interactions between mivacurium and pancuronium
Department of Anaesthesiology, College of Medicine, Hanyang University Hospital, #17 Haengdang dong, Songdong-Ku, Seoul 133-792, Korea
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