Interaction between Mivacurium and Nitroglycerin.
10.4097/kjae.2001.40.2.163
- Author:
In Su HAN
1
;
Jae Chol SHIM
;
Jeong Woo JEON
;
Jun Ro YUN
;
Chang Soo HONG
;
Jang Hyuk MUN
;
Ho Sik MUN
;
Chul Woo LEE
Author Information
1. Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Interactions, drug: mivacurium;
nitroglycerine;
Monitoring: train-of-four;
Neuromuscular relaxants: mivacurium
- MeSH:
Adult;
Anesthesia;
Fentanyl;
Humans;
Isoflurane;
Middle Aged;
Neuromuscular Blockade;
Neuromuscular Monitoring;
Nitroglycerin*;
Thiopental
- From:Korean Journal of Anesthesiology
2001;40(2):163-168
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The neuromuscular blocking effects of a nondepolarizing neuromuscular blocker (NDNM) during a nitroglycerin (NTG) infusion were significantly potentiated and prolonged. NTG reduced the requirement of a NDNM in surgical patients. We investigated the influence of a NTG single bolus injection on a mivacurium nuromuscular blockade. METHODS: We studied 36 adult surgical patients, ASA physical status I or II, between 15 and 53 years old. Neuromuscular monitoring was measured by TOF-GUARD (Biometer Co., Denmark). Anesthesia was induced by thiopental sodium 3-5 mg/kg and fentanyl 3 microgram/kg, and maintained with 3 L/min N2O, 2 L/min O2 and 1 vol.% isoflurane. Patients were randomly assigned to 3 groups: 1) Control group (mivacurium 0.16 mg/kg), 2) N100 group (mivacurium 0.16 mg/kg, NTG 100 microgram), 3) N200 group (mivacurium 0.16 mg/kg, NTG 200 microgram). We measured the train-of-four (TOF) response from the beginning of recovery to the complete regaining of muscle twitch. RESULTS: NTG produced a prolongation of the neuromuscular blocking effect by mivacurium. T1 (contro group: 12.1 +/- 0.5, N100 group: 15.8 +/- 0.4 and N200 group: 11.6 +/- 0.4 min), T25 (16.4 +/- 0.4, 20.5 +/- 0.5 and 14.9 +/- 1.0 min), T75 (22.5 +/- 0.9, 29.4 +/- 0.7 and 20.1 +/- 1.0 min), T95 (27.3 +/- 0.6, 39.6 +/- 0.7 and 24.6 +/- 1.5 min) and the recovery index (6.1 +/- 0.6, 9.0 +/- 0.4 and 5.3 +/- 0.7 min) were significantly prolonged in the N100 and N200 groups (P < 0.05). CONCLUSION: These results suggest that a NTG bolus injection prolonged the neuromuscular blocking effect of mivacurium, dose relatively.