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KMID : 0378020090520030015
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New Medical Journal
2009 Volume.52 No. 3 p.15 ~ p.19
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Interaction Between Mivacurium and Continuous Venous Infused Nitroglycerin
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Han In-Soo
Shim Hyo-Sun
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Abstract
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Background: During continuous infusion of nitroglycerin (NTG), the neuromuscular blocking effects of nondepolarizing neuromuscular blocker (NDNM) were prolonged and potentiated. NTG reduced the requirement of NDNM in anesthetized patients. We investigated the influence of the NTG continuous infusion on mivacuriumi induced neuromuscular blockade.
Method: We studied 60 adult anesthetized patients, ASA physical status I or II, between 18 and 64 years old. Neuromuscular monitoring was measured by TOF-GUARD? (Biometer CO., Denmark). The induction of anesthesia in patients was done by thiopental sodium 3-5 mg/kg and fentanyl citrate 3 ug/kg, and maintained with 2 L/min N2O, 2 L/min
O2 and 1 vol% enflurane. Patients were randomly assigned to 2 groups: 1) Control group (mivacurium 0.16 mg/kg), 2) NTG group (mivacurium 0.16 mg/kg+NTG 0.5 ug/kg/min). We measured the train-of-four (TOF) response from the beginning of recovery to the complete regaining of muscle twitch.
Results: NTG induced a prolongation of the mivacurium action duration. T1(control group: 11.7±0.2 min, NTG group: 15.9±0.3 min), T25 (control group 14.8±0.7 min, NTG group 20.4±0.4 min), T75(control group 20.3±0.9 min, NTG group 29.3±0.6 min), Table3). T95(control group: 24.6±1.3 min, NTG group 39.7±0.6 min) and recovery index
(control group 5.4±0.7 min, NTG group 9.0±0.4 min) were significantly prolonged in NTG group (P<0.05).
Conclusion: Theses results suggest that continuous infusion of NTG prolonged the neuromuscular blocking effect of mivacurium.
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KEYWORD
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Interactions, drug: mivacurium, nitroglycerine, Monitoring: train-of-four. Neuromuscular relaxants: mivacurium
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