Pharmacodynamics of mivacurium in severely burned patients

The pharmacodynamics of mivacurium, a new short-acting non-depolarizing muscle relaxant, were studied in nine severely burned patients with concomitant inhalation injury. Complete neuromuscular blockade was achieved within 1.3 min (controls 3.0 min) following the usually recommended intubating dose (0.15 mg/kg/BW 2 x ED95) of mivacurium. The clinical duration of neuromuscular blockade and the recovery times were slightly prolonged, due to significantly reduced serum cholinesterase activity (clinical duration 24.6 min vs. 15.3 min). This pharmacodynamic profile makes mivacurium preferable for intermittent on-demand neuromuscular blockade in the severely burned patient.