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  • Title: [Pharmacodynamics and safety of mivacurium in infants and children under halothane-nitrous oxide anesthesia].
    Author: Plaud B, Goujard E, Orliaguet G, Meistelman C, Ecoffey C.
    Journal: Ann Fr Anesth Reanim; 1999 Dec; 18(10):1047-53. PubMed ID: 10652937.
    Abstract:
    OBJECTIVES: To determine pharmacodynamic effects and safety of mivacurium in paediatric patients. STUDY DESIGN: Multicentric, prospective, open, non-randomized study. PATIENTS: Forty-eight three-month-old to eight-year-old physical class ASA I or II children. METHOD: Anaesthesia was induced and maintained with halothane and nitrous oxide. Tracheal intubation was performed without a neuromuscular blocking agent. Neuromuscular blockade was measured with a strain force transducer after train-of-four stimulation of the ulnar nerve at the wrist every ten seconds. A single bolus dose of mivacurium (0.2 mg.kg-1) was injected during 15 seconds in patients allocated into three groups. Group 1: three to 12-month-old infants (n = 15), group 2: one- to three-year-old children (n = 16) and group 3: three- to eight-year-old children (n = 17). Onset and recovery parameters were measured in each patient. Heart rate and noninvasive arterial blood pressure were recorded every minute for five minutes after mivacurium injection. RESULTS: Following halothane administration for 29 and 32 min, and a FEThalothane = 1 vol%, mivacurium (0.2 mg.kg-1) determined a 100% neuromusmcular blockade in all patients. The onset time was 71 +/- 34 s (mean +/- SD) in all patients and did not differ between groups. Time to 25% and 95% recovery of the first twitch and recovery index for all the patients were 12 +/- 3 min, 19 +/- 5 min and 4 +/- 2 min respectively and did not differ between groups. No prolonged paralysis was observed. No significant changes of HR and BP occurred. CONCLUSIONS: Following 0.2 mg.kg-1 of mivacurium in patients aged between three months to eight years, a complete blockade occurs with a rapid onset time and a short duration of action, without significant cardiovascular effect.
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