Comparison of the neuromuscular effects of mivacurium and suxamethonium in infants and children

Acta Anaesthesiol Scand Suppl. 1995:106:35-40. doi: 10.1111/j.1399-6576.1995.tb04307.x.

Abstract

We compared both the time course of neuromuscular blockade and the cardiovascular side-effects of suxamethonium and mivacurium during halothane and nitrous oxide anaesthesia in infants 2-12 months and children 1-12 years of age. Equipotent doses of mivacurium and suxamethonium were studied; 2.2 x ED95 was used in four groups of infants and children, while 3.4 x ED95 was used in two groups of children. Onset of neuromuscular block in infants was not significantly faster with suxamethonium than with mivacurium (P = 0.2). In all infants given suxamethonium, intubating conditions were excellent, while, in 6/10 infants given mivacurium, intubating conditions were excellent. Onset of complete neuromuscular block in children was significantly faster with suxamethonium, 0.9 min compared with mivacurium, 1.4 min (P < or = 0.05). Increasing the dose of suxamethonium or mivacurium in children to 3.4 x ED95 did not change the onset of neuromuscular block. Recovery of neuromuscular transmission to 25% of initial twitch height (T25) in infants and children was significantly faster after suxamethonium than after mivacurium, at 2.5 and 6 min, respectively (P < or = 0.05). In children given 3.4 x ED95 of suxamethonium or mivacurium, recovery from neuromuscular block was almost identical with the dose of 2.2 x ED95, with spontaneous recovery to T25 prolonged by only 0.5 min. No infant or child had hypotension after the mivacurium bolus dose.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Anesthesia Recovery Period
  • Anesthesia, Inhalation
  • Anesthetics, Inhalation / administration & dosage
  • Blood Pressure / drug effects
  • Child
  • Child, Preschool
  • Cholinesterases / blood
  • Halothane / administration & dosage
  • Heart Rate / drug effects
  • Humans
  • Hypotension / chemically induced
  • Infant
  • Intubation, Intratracheal
  • Isoquinolines / administration & dosage*
  • Mivacurium
  • Neuromuscular Depolarizing Agents / administration & dosage*
  • Neuromuscular Junction / drug effects
  • Neuromuscular Nondepolarizing Agents / administration & dosage*
  • Nitrous Oxide / administration & dosage
  • Succinylcholine / administration & dosage*
  • Synaptic Transmission / drug effects
  • Time Factors

Substances

  • Anesthetics, Inhalation
  • Isoquinolines
  • Neuromuscular Depolarizing Agents
  • Neuromuscular Nondepolarizing Agents
  • Mivacurium
  • Cholinesterases
  • Succinylcholine
  • Nitrous Oxide
  • Halothane