Korean J Anesthesiol.  1998 Oct;35(4):679-683. 10.4097/kjae.1998.35.4.679.

The Neuromuscular Effects of Succinylcholine, Mivacurium and Vecuronium Corresponding to the Blood Flow Occlusion of Time in the Isolated Forearm

• Kim SI
• Heo HM
• Doh SJ
• Lee JS
• Kim SC
• Kim SY

• KMID: 2091279
• DOI: http://doi.org/10.4097/kjae.1998.35.4.679

Abstract

BACKGREOUND: The magnitude of neuromuscular blockade is related to plasma concentration of muscle relaxants. This study was designed to compare the maximal depression of twitch height by blood flow occlusion using a tourniquet at various time interval after intravenous administration of muscle relaxants. METHOD: We studied 127 healthy male adult patients who underwent elective surgery under the general anesthesia with propofol infusion and 50% nitrous oxide. The single supramaximal twitch stimulation applied to the ulnar nerve at the wrist at 1 Hz. The twitch response of adductor pollicis muscles were measured by a 2 kg Load Cell strain gauge with a thumb piece modification and recorded by a Gould TA 240 recorder. After occlusion of blood flow by the tourniquet in the upper arm, in which the neuromuscular monitoring was applied on the wrist, we administered the equipotent dose (ED95) of succinylcholine (S group), mivacurium (M group), and vecuronium (V group) intravenously on the contralateral arm respectively. We measured the maximal depression (%) of twitch height after the releasing tourniquet at 30, 60, 90, 120, 150, and 240 second intervals after the injection of each drug.
RESULTS
The depression of twitch height was not found from 90 seconds of tourniquet time in the M group, and 120 seconds of tourniquet time in the S group. However, in the V group, the depression of twitch height was maintained to 240 seconds of tourniquet time.
CONCLUSIONS
It is suggested that the plasma concentration of mivacurium declined faster than that of succinylcholine, and that of vecuronium decreased slowest among the groups after intravenous administration of equipotent dose (ED95).

Keyword

Neuromuscular relaxants: succinylcholine; mivacurium; vecuronium; Pharmacokinetics: neuromuscular blockade; Neuromuscular transmission: twitch response

MeSH Terms

Administration, Intravenous
Adult
Anesthesia, General
Arm
Depression
Forearm*
Humans
Male
Muscles
Neuromuscular Agents*
Neuromuscular Blockade
Neuromuscular Monitoring
Nitrous Oxide
Plasma
Propofol
Succinylcholine*
Thumb
Tourniquets
Ulnar Nerve
Vecuronium Bromide*
Wrist
Neuromuscular Agents
Nitrous Oxide
Propofol
Succinylcholine
Vecuronium Bromide