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Interactions between mivacurium and atracurium
M Naguib1, M Abdulatif, A al-Ghamdi
1Department of Anaesthesia and ICU, King Saud University, Faculty of Medicine at King Khalid University Hospital, Riyadh, Saudi Arabia.
British Journal of Anaesthesia
|October 1, 1994
Summary
Atracurium and mivacurium exhibit additive effects when combined, meaning their neuromuscular blocking actions are equivalent to the sum of their individual effects. This additive interaction was confirmed through detailed dose-response studies and analyses.
Area of Science:
- Anesthesiology
- Pharmacology
- Neuromuscular Pharmacology
Background:
- Atracurium and mivacurium are neuromuscular blocking agents used in anesthesia.
- Understanding drug interactions is crucial for safe and effective anesthetic practice.
Purpose of the Study:
- To investigate the interaction between atracurium and mivacurium.
- To quantitatively assess the combined neuromuscular blocking effects of these agents.
Main Methods:
- Dose-response relationships were studied in 96 patients.
- Neuromuscular block was measured using mechanomyography and train-of-four stimulation.
- Isobolographic and fractional analyses were employed to determine interaction type.
Main Results:
- The ED50 for atracurium was 50.5 µg/kg and for mivacurium was 20.8 µg/kg.
- Isobolographic and fractional analyses demonstrated zero interaction (additivity) between atracurium and mivacurium.
- Maintenance doses of mivacurium showed a significantly longer duration of action when preceded by atracurium.
Conclusions:
- Atracurium and mivacurium exhibit an additive interaction.
- This finding has implications for dose adjustments and clinical use of these neuromuscular blocking agents in combination.