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KMID : 0378020090520050032
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New Medical Journal
2009 Volume.52 No. 5 p.32 ~ p.35
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Effect of Vecuronium on Mivacurium-induced Neuromuscular Block Recovery
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Han In-Soo
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Abstract
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Background: Neuromuscular blocking effect of mivacurium is prolongated by addition of low-dose other nondepolarizing muscle relaxants (NMDA). Nevertheless, an interaction at the receptor site could not be ruled out. By addition of low dose vecuronium, we may lessen the pharmacokinetic interaction. We investigated the influence of the low dose vecuronium addition on mivacurium induced neuromuscular blockade.
Method: We studied 20 adult anesthetized patients, ASA physical status I or II, between 18 and 60 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) Miva group (mivacurium 0.16 mg/kg), 2) Miva-vec group (mivacurium 0.16 mg/kg+vec 15 ug/kg). We measured the train-of-four (TOF) response from the beginning of recovery to the complete regaining of muscle twitch.
Results: Vecuronium induced a prolongation of the mivacurium action duration. T25 (Miva group 15.1±1.0 min, Miva-vec group 20.7±8.0 min), T75(Miva 20.3±1.0 min, Miva-vec group 24.1±9.0 min), and T95(Miva: 24.9±2.0 min, Miva-vec group 45.0±7.0 min) were significantly prolonged in Miva-vec group (p<0.05)(Table 1).
Conclusion: Theses results suggest that addition of low dose vecuronium prolonged the neuromuscular blocking effect of mivacurium.
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KEYWORD
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Interactions, Drug: mivacurium, vecuronium, Monitoring: train-of-four, Neuromuscular relaxants: mivacurium, Vecuronium
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