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Mivacurium chloride for short laparoscopic procedures
P E Pendeville1, P Laloyaux, B Fraselle
1Departement of Anaesthesiology, UCL Medical School, Saint-Luc Hospital, Brussels, Belgium.
Acta Anaesthesiologica Belgica
|January 1, 1995
Summary
A higher dose of mivacurium (0.19 mg/kg) facilitated faster intubation during fentanyl-propofol anesthesia. This dose, however, prolonged neuromuscular block duration, suggesting careful consideration for its use in outpatient surgery.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Fentanyl-propofol anesthesia is common for induction.
- Mivacurium is a neuromuscular blocking agent with variable duration.
- Optimizing neuromuscular blockade for intubation and recovery is crucial.
Purpose of the Study:
- To evaluate the effects of different mivacurium bolus doses on intubation conditions and recovery times.
- To determine the optimal mivacurium dosage for rapid sequence induction in fentanyl-propofol anesthesia.
Main Methods:
- Healthy adult women received fentanyl-propofol anesthesia.
- Three mivacurium bolus doses (0.15, 0.17, 0.19 mg/kg) were administered.
- Neuromuscular blockade was monitored using a myorelaxograph and Train of Four (TOF) stimulation.
Main Results:
- Intubation conditions were good to excellent across groups.
- Successful intubation was significantly faster with the 0.19 mg/kg mivacurium dose (p = 0.017).
- The 0.19 mg/kg dose resulted in a significantly longer curarization time (p = 0.002) and prolonged recovery.
Conclusions:
- A mivacurium bolus dose of 0.19 mg/kg is optimal for rapid sequence induction with fentanyl-propofol.
- Mivacurium's potential for prolonged neuromuscular blockade requires consideration for outpatient settings.
- No significant impact on vital signs was observed with the tested mivacurium doses.