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[Infusion of mivacurium and atracurium guided by manual tactile evaluation]
N A Pedersen1, D Østergaard, J S Olsen
1Anaestesiologisk afdeling, Amtssygehuset i Gentofte.
Introduction:
The aim of this investigation was to compare the use of a continuous infusion of mivacurium or atracurium guided by tactile evaluation of the neuromuscular block.
Materials And Methods:
Forty-five patients were randomly allocated to three groups of patients. Group M and MN received a bolus dose of mivacurium 0.15 mg/kg followed by a continuous infusion and group AN a bolus dose of atracurium 0.4 mg/kg followed by an infusion.
Results:
The neuromuscular blockade recovered spontaneously in group M and was antagonised in group MN and AN. The level of block was quantified by tactile evaluation. The time to full recovery was significantly shorter in patients receiving mivacurium compared to patients given atracurium, 14.5, 12.0 and 18.0 min, respectively. Further, reversal with neostigmine significantly enhanced recovery following mivacurium.
Conclusion:
A continuous infusion of mivacurium and atracurium can easily be performed, guided by tactile evaluation of the neuromuscular block and the effect can be reversed by neostigmine.
Insights
Continuous infusions of mivacurium and atracurium, guided by tactile neuromuscular block evaluation, offer effective anesthesia. Mivacurium demonstrated faster recovery times compared to atracurium.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Neuromuscular blocking agents are crucial in anesthesia.
- Comparing mivacurium and atracurium infusions is important for clinical practice.
Purpose of the Study:
- To compare continuous infusions of mivacurium and atracurium.
- To evaluate tactile assessment for guiding neuromuscular block infusions.
- To assess recovery times and reversal efficacy.
Main Methods:
- 45 patients were randomized into three groups.
- Groups received either mivacurium or atracurium infusions.
- Neuromuscular block depth was assessed using tactile evaluation.
Main Results:
- Mivacurium infusions led to significantly shorter recovery times (14.5 min) versus atracurium (18.0 min).
- Neostigmine reversal significantly improved recovery in the mivacurium group (12.0 min).
- Tactile evaluation effectively guided infusion rates.
Conclusions:
- Continuous infusions of mivacurium and atracurium are feasible with tactile guidance.
- Mivacurium offers a faster recovery profile than atracurium.
- Neostigmine is an effective reversal agent for mivacurium-induced block.