Abstract
Study Objective: To determine the potentiation of the neuromuscular blockade induced by a titrated infusion of mivacurium in the presence of isoflurane versus a nitrous oxide (N 2O)-opioid anesthesia. Design: An open-label, controlled study. Setting: The inpatient anesthesia service of two university medical centers. Patients: Thirty adults divided into two groups. Intervention: An intravenous infusion of mivacurium during anesthesia with N20opioid or N 2O-isoflurane. Measurements and Main Results: A neuromuscular blockade was monitored by recording the electromyographic activity of the adductor pollicis muscle resulting from supramaximal stimulation at the ulnar nerve at 2 Hz for 2 seconds at 10-second intervals. The mivacurium infusion rate was significantly less in the presence of isofurane [4.0 ± 0.8 μg/kg/min (mean ± SEM)] than during N 2O-opioid anesthesia (6.4 ± 0.6 μg/kg/min). The recovery rates did not differ between anesthetic groups. After the termination of the infusion, spontaneous recovery to T 4/T 1 of at least 0.75 occurred in an average of 17.9 ± 1.5 minutes, with a mean recovery index (T 25−75) of 6.0 ± 0.7 minutes. Conclusion: Isofurane anesthesia reduces the infusion rate of mivacurium required to produce about 95% depression of neuromuscular function.
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