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Dose—response and minimum time to satisfactory intubation conditions after mivacurium in children
Author(s) -
McCLUSKEY A.,
MEAKIN G.
Publication year - 1996
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1996.tb07787.x
Subject(s) - medicine , anesthesia , intubation , alfentanil , confidence interval , nitrous oxide , neuromuscular blockade , tracheal intubation , adductor pollicis muscle , potency , neuromuscular transmission , surgery , propofol , biochemistry , chemistry , elbow , ulnar nerve , in vitro
Summary We assessed neuromuscular blocking effects and tracheal intubation conditions following mivacurium in 121 anaesthetised children aged 1–10 years. The study was conducted in three parts. Parts 1 and 2 were undertaken during thiopentone—alfentanil—nitrous oxide anaesthesia; neuromuscular blockade was evaluated by recording the force of contraction of the adductor pollicis in response to train‐of‐four stimulation at 0.I Hz. In part 1 the potency of mivacurium was determined in 15 children using a single dose‐response technique; in part 2 onset and recovery times were determined in six children following a dose of mivacurium 0.2mg.kg ‐1 . In part 3 of the study, clinical intubation conditions were assessed in two groups of 50 children whose tracheas were intubated 60 or 90s after injection of mivacurium 0.2mg.kg ‐1 during thiopentone—nitrous oxide anaesthesia. The ED 50 and ED 95 ; of mivacurium were 54 and 105 ug.kg ‐1 respectively. The times to 90% and 100% depression of control twitch were 1.3 (0.3) and 1.9 (0.5) min; times to 5%, 25%, 75% and 90% recovery were 6.4 (1.0), 8.4 (1.1), 12.5 (1.1) and 14.4 (1.9) min, respectively. Intubation conditions were rated satisfactory in 33/50 children (0.66, 95% confidence interval 0.51–0.79) at 60s and in 49/50 children (0.98, 95% confidence interval 0.89–1.0) at 90s (p = 0.0001). Intubation conditions 90s after mivacurium 0.2mg.kg ‐1 were significantly better than those obtained in 10 patients given anaesthetic drugs alone (p = 0.002).