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
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.