Related Experiment Video
Updated: Aug 8, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
[Mivacurium--use for complications of facial-cranial surgery--personal experience]
A Macheta1, T Muszyński, H Podziorny
1Katedra Anestezjologii i Intensywnej Terapii Collegium Medicum Uniwersytetu Jagiellońskiego ul. Kopernika 17, 31-501 Kraków.
Abstract:
The aim of this study was to evaluate the effectiveness of mivacurium (Mivacron--GlaxoWellcome) during combined general anaesthesia in the operations on the facial cranium, after tracheal intubation performed using suxamethonium chloride (Chlorsuccillin--Polfa PL). We examined 20 patients, 17-65 years old, who were underwent operations due to facial and neck neoplasms or trauma. Patients were divided into two 10-person groups. In first group the dose of Mivacron for the induction of anaesthesia was 0.15 mg/kg of body weight, in second group the dose was 0.1 mg/kg of body weight. Next doses used during maintenance of anaesthesia were 0.1 mg/kg of body weight in both groups. Metohexital, fentanyl, nitrous oxide and oxygen were used for the maintenance of anaesthesia. The level of neuromuscular block was estimated using Ministim MS IIIA instrument. The mean time to maintain 95-99% neuromuscular block after inductive dose 0.15 mg/kg Mivacron was 15 minutes 26 seconds, and after the dose of 0.1 mg/kg--13 minutes 55 seconds. The time from the injection of the drug to maintain neuromuscular block was 1 minute 52 seconds and 1 minute 50 seconds, respectively. We did not observe neither negative influence of drug on the cardiovascular system nor the reactions of histamine release. Injection of suxamethonium chloride before the tracheal intubation did not prolong the time of Mivacron activity. Anticholinesterase agents was not use in any case. By 4 patient with heart failure prolongation of the activity time of Mivacurium was observed. The dose of 0.1 mg/kg, is efficient to maintain of the neuromuscular block on the stabile level. This allows the reduction of the total dose, and the decrease of the costs of the operation.
Insights
Mivacurium effectively maintains neuromuscular block during facial surgeries. A 0.1 mg/kg dose is sufficient for stable block, reducing costs without adverse cardiovascular or histamine effects.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Facial surgeries require effective neuromuscular blockade for optimal patient and surgical outcomes.
- Mivacurium is a short-acting, non-depolarizing neuromuscular blocking agent used in anesthesia.
Purpose of the Study:
- To evaluate the efficacy and safety of mivacurium for neuromuscular block during general anesthesia for facial and neck surgeries.
- To determine optimal dosing for mivacurium induction and maintenance in this patient population.
Main Methods:
- A study involving 20 patients undergoing facial/neck surgeries under general anesthesia.
- Patients received either 0.15 mg/kg or 0.1 mg/kg mivacurium for induction, followed by 0.1 mg/kg for maintenance.
- Neuromuscular block was monitored using a quantitative neuromuscular transmission monitor (Ministim MS IIIA).
Main Results:
- Both induction doses (0.15 mg/kg and 0.1 mg/kg) provided rapid onset of neuromuscular block.
- The 0.1 mg/kg maintenance dose effectively sustained neuromuscular block.
- No significant adverse cardiovascular effects or histamine release reactions were observed.
- Prior administration of suxamethonium chloride did not prolong mivacurium's activity.
Conclusions:
- Mivacurium is a safe and effective neuromuscular blocking agent for facial and neck surgeries.
- A maintenance dose of 0.1 mg/kg mivacurium provides stable neuromuscular block.
- Using lower doses of mivacurium can reduce total drug administration and associated costs.
