Intubating conditions and blockade after mivacurium, rocuronium and their combination in young and elderly adults

Citation
C. Motamed et F. Donati, Intubating conditions and blockade after mivacurium, rocuronium and their combination in young and elderly adults, CAN J ANAES, 47(3), 2000, pp. 225-231
Citations number
31
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
ISSN journal
0832610X → ACNP
Volume
47
Issue
3
Year of publication
2000
Pages
225 - 231
Database
ISI
SICI code
0832-610X(200003)47:3<225:ICABAM>2.0.ZU;2-K
Abstract
Purpose: Mivacurium-rocuronium combinations have been demonstrated to be mo re potent than either drug given alone. Combinations were compared with miv acurium and rocuronium, with respect to onset, intubating conditions, and d uration of action in young and elderly adults. Methods: Fentanyl-propofol-N2O-isoflurane anesthesia was given to ASA I and II adults aged 18-65 yr (45 patients) and over 66 yr (45 patients), In thi s blinded randomized study, we compared accelerographic adductor pollicis r esponse and visual assessment of response to facial nerve stimulation after 0.25 mg.kg(-1) mivacurium, 0.6 mg.kg(-1) rocuronium, and a combination of 0.08 mg.kg(-1) mivacurium plus 0.2 mg.kg(-1) rocuronium. Intubating conditi ons at 2.5 min were rated as excellent, good, fair or poor. Results: Onset times were similar for all drugs regimens and for both age g roups (204-276 sec at the thumb; 142-196 sec at the eye) (P < 0.05 between muscles). Intubating conditions were similar in all groups, and rated good or excellent, except in two subjects, In young patients duration to 25% rec overy was longer (P < 0.05) for rocuronium (mean +/- SD) (39 +/- 11 min) th an for either mivacurium (23 +/- 6 min), or the combination (27 +/- 7 min). Duration was prolonged in the elderly for rocuronium (54 +/- 17 min), and the combination ( 35 +/- 11 min), but not for mivacurium (24 +/- 6 min), Conclusions: Mivacurium-rocuronium combinations yield onset times and intub ating conditions similar to either parent agent with only two thirds as muc h total drug. Duration for such a mixture is similar to that of mivacurium in young adults and slightly prolonged in the elderly.