Sequential method for determining the maximum dose of mivacurium continuously infused for intraoperative neuromonitoring in thyroid surgery.
10.12122/j.issn.1673-4254.2018.12.12
- Author:
Yongjie CHEN
1
;
Lianjun HUANG
1
;
Yang LI
1
;
Li TONG
1
;
Xiaochen WANG
1
;
Keshi HU
1
;
Zeguo FENG
1
Author Information
1. Anesthesia and Operation Center, General Hospital of PLA, Beijing 100853, China.
- Publication Type:Journal Article
- Keywords:
intraoperative neuromonitoring;
mivacurium;
thyroid surgery
- MeSH:
Anesthesia;
Anesthetics, Inhalation;
Anesthetics, Intravenous;
Humans;
Intraoperative Neurophysiological Monitoring;
methods;
Lethal Dose 50;
Mivacurium;
administration & dosage;
adverse effects;
Neuromuscular Nondepolarizing Agents;
administration & dosage;
adverse effects;
Remifentanil;
Sevoflurane;
Thyroid Gland;
surgery
- From:
Journal of Southern Medical University
2018;38(12):1472-1475
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To determine the maximum dose of continuously infused mivacurium for intraoperative neuromonitoring and observe its adverse effects in thyroid surgery.
METHODS:Twenty-eight patients undergoing thyroid surgery with intraoperative neuromonitoring received continuous infusion of mivacurium at the initial rate of 5.43 μg?kg?min, and the infusion rate for the next patient was adjusted based on the response of the previous patient according to the results of neurological monitoring. The depth of anesthesia was maintained with sevoflurane and remifentanil during the surgery. The LD50 and 95% of mivacurium were calculated using Brownlee's up-and-down sequential method.
RESULTS:The LD50 of continuously infused mivacurium was 8.94 μg?kg?min (95% : 8.89- 8.99 μg?kg?min) during thyroid surgery, which did not affect neurological function monitoring. Transient chest skin redness occurred after induction in 9 patients (32.1%). None of the patients experienced intubation difficulties or showed intraoperative body motions during the surgery.
CONCLUSIONS:In patients undergoing thyroid surgery under anesthesia maintained by inhalation and intravenous infusion, the LD50 of mivacurium was 8.94 μg?kg?min (95% : 8.89-8.99 μg?kg?min) for continuous infusion, which does not cause serious adverse effects during the operation.
