Interactions between mivacurium, rocuronium, and vecuronium during general anesthesia

Dae Woo Kim, Girish P. Joshi, Paul F. White, Edward R. Johnson

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

This study was designed to examine the interactions between mivacurium and rocuronium or vecuronium when administered during a standardized anesthetic technique. Seventy healthy women undergoing abdominal hysterectomy procedures with a standardized thiopental-sufentanil-desflurane-nitrous oxide anesthetic technique were randomly assigned to one of seven treatment groups (10 patients each). After a tracheal intubating dose of vecuronium 100 μg/kg (Groups 1 and 2), rocuronium 600 μg/kg (Groups 3 and 4), or mivacurium 250 μg/kg (Groups 5, 6, and 7), patients received vecuronium, 25 μg/kg (Groups 1 and 6), rocuronium 150 μg/kg (Groups 3 and 7), or mivacurium 50 μg/kg (Groups 2, 4, and 5) for maintenance of neuromuscular blockade. Neuromuscular function was assessed using electromyography, with a train-of-four mode of stimulation at the wrist every 10 s. The clinical duration (time for T1 to return to 25% of baseline) of the maintenance dose of mivacurium was significantly longer after an intubating dose of rocuronium (40 ± 8 min) and vecuronium (28 ± 6 min) than after mivacurium (12 ± 3 min). The clinical duration of maintenance doses of vecuronium (18 ± 6 min) and rocuronium (13 ± 2 min) were significantly shorter after an intubating dose of mivacurium than that after an intubating dose of vecuronium (30 ± 5 min) or rocuronium (42 ± 12 min), respectively. These data suggest that with consecutive administration of neuromuscular blocking drugs, the initial duration of action depends more on the kinetics of the first neuromuscular blocking drug than the subsequent drug. Thus, there appears to be no clinical advantage in using mivacurium for maintenance of neuromuscular blockade after initial administration of rocuronium or vecuronium.

Original languageEnglish (US)
Pages (from-to)818-822
Number of pages5
JournalAnesthesia and Analgesia
Volume83
Issue number4
DOIs
StatePublished - 1996

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Vecuronium Bromide
General Anesthesia
Neuromuscular Blockade
Anesthetics
Maintenance
Pharmaceutical Preparations
Sufentanil
Thiopental
Nitrous Oxide
Electromyography
mivacurium
rocuronium
Wrist
Hysterectomy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Interactions between mivacurium, rocuronium, and vecuronium during general anesthesia. / Kim, Dae Woo; Joshi, Girish P.; White, Paul F.; Johnson, Edward R.

In: Anesthesia and Analgesia, Vol. 83, No. 4, 1996, p. 818-822.

Research output: Contribution to journalArticle

Kim, Dae Woo ; Joshi, Girish P. ; White, Paul F. ; Johnson, Edward R. / Interactions between mivacurium, rocuronium, and vecuronium during general anesthesia. In: Anesthesia and Analgesia. 1996 ; Vol. 83, No. 4. pp. 818-822.
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