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[Conditions of intubation and neuromuscular block induced by mivacurium: comparison with succinylcholine]

A L Fuentes de Frutos1, C Muriel Villoria, M T Romo Cortina

  • 1Servicio de Anestesiología, Complejo Hospitalario Hospital General, Segovia.

Revista Espanola De Anestesiologia Y Reanimacion
|June 12, 1999
PubMed
Abstract

Insights

Mivacurium, a neuromuscular relaxant, offers good intubation conditions but has a slower onset than succinylcholine. It is not ideal for rapid sequences but can be an alternative in elective surgery.

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Neuromuscular blocking agents are crucial for endotracheal intubation.
  • Succinylcholine is a common choice, but its use can be associated with side effects.
  • Mivacurium offers an alternative with a different pharmacokinetic profile.

Purpose of the Study:

  • To compare the clinical intubation conditions and neuromuscular parameters of a high dose of mivacurium with succinylcholine.
  • To evaluate mivacurium as a potential alternative to succinylcholine in anesthesia.

Main Methods:

  • A randomized study of 82 patients comparing mivacurium (0.25 mg/kg) and succinylcholine (1 mg/kg).
  • Intubating conditions assessed by laryngoscopy, vocal cord relaxation, and cough at 60 seconds.
  • Neuromuscular blockade monitored via train-of-four stimulation; hemodynamic parameters and cutaneous flush recorded.

Main Results:

  • Mivacurium showed a significantly longer onset and recovery time compared to succinylcholine.
  • Excellent/good intubation conditions were achieved in 95.6% of mivacurium cases with 52.68% neuromuscular blockade.
  • No significant hemodynamic changes or adverse effects were observed with mivacurium.

Conclusions:

  • Mivacurium is not recommended for rapid sequence induction due to moderate intubation conditions at 60 seconds.
  • Mivacurium at 0.25 mg/kg can be considered a viable alternative to succinylcholine for elective surgery.
  • Further research may explore optimal dosing for rapid intubation scenarios.

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