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Priming technique accelerates the onset time of mivacurium in children during halothane anesthesia
1Department of Anesthesiology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Insights
Priming with mivacurium significantly speeds up neuromuscular blockade onset for tracheal intubation in children. This method enhances the rapid action of mivacurium (a muscle relaxant) during pediatric surgery.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacology
Background:
- Mivacurium is a neuromuscular blocking agent used for tracheal intubation in children.
- Its rapid onset makes it a suitable choice for pediatric procedures.
- This study investigates the effect of a priming dose on mivacurium's neuromuscular effects in children.
Purpose of the Study:
- To compare the neuromuscular effects of mivacurium with and without a priming dose in pediatric patients.
- To evaluate the onset time of neuromuscular blockade.
- To assess the influence of priming on recovery and side effects.
Main Methods:
- Forty pediatric patients (2-10 years) were randomly assigned to a non-priming or priming group.
- The priming group received a small initial dose of mivacurium before the main intubating dose.
- Neuromuscular monitoring was performed using electromyography during halothane anesthesia.
Main Results:
- The onset of neuromuscular blockade was significantly faster in the priming group (1.04 min) compared to the non-priming group (1.7 min).
- Priming did not affect the time to spontaneous recovery of neuromuscular function.
- Adverse effects like flushing and hypotension were minimal.
Conclusions:
- Priming with mivacurium significantly accelerates its onset in pediatric patients.
- This technique can be beneficial for optimizing tracheal intubation conditions in children under halothane anesthesia.
- Mivacurium priming is effective and well-tolerated in this population.
Background:
Mivacurium is considered a relaxant suitable for tracheal intubation in children due to its rapid onset. We compared the neuromuscular effects of mivacurium, with and without priming, in children undergoing elective surgery during halothane anesthesia.
Methods:
Forty pediatric patients (2-10 yr, ASA class I) were randomly into 2 groups and studied under halothane anesthesia. The non-priming group (n = 20) received mivacurium 0.25 mg/kg, and the priming group (n = 20) received a priming dose of mivacurium 0.025 mg/kg, followed by an intubating dose of 0.225 mg/kg 3 min later. Thenar Electromyogram responsive to supramaximal train-of-four stimulation of the ulnar nerve at 12 s intervals was used as neuromuscular monitoring.
Results:
The onset time in the priming group was significantly faster than in the non-priming group (1.04 min vs. 1.7 min). The mean time from injection of intubating dose to spontaneous recovery to 25%, 50% and 75% twitch were not influenced by priming technique. Side effects, such as cutaneous flushing and hypotension, were unremarkable at this dose in children.
Conclusions:
Priming technique can significantly accelerates the onset of mivacurium in the pediatric patients under halothane anesthesia.