Yonsei Med J.  1999 Aug;40(4):371-376. 10.3349/ymj.1999.40.4.371.

The infusion rate of mivacurium or atracurium for cesarean section compared with gynecological procedures

• Kim JH
• Min KT
• Ahn EK
• Kim KH
• Shin YS

• KMID: 711664
• DOI: http://doi.org/10.3349/ymj.1999.40.4.371

Abstract

Mivacurium is mainly metabolized by plasma cholinesterase, whereas atracurium is removed by Hofman elimination. The purpose of this study was to compare the infusion rate of atracurium and mivacurium in maintaining surgical relaxation, and to compare their recovery indices between parturients and non-pregnant women. Muscle relaxation was maintained by the continuous infusion of relaxants to retain the first response of train-of-four (TOF) at 5% of control. When mivacurium was used, Bolus-T5 (duration from the end of mivacurium bolus injection to 5% single twitch recovery) was measured. After discontinuing the infusion, the recovery index was measured. The infusion rate of mivacurium, not atracurium, was significantly lower in parturients and Bolus-T5 of parturients was significantly longer than that of non-pregnant women. There was no significant difference in the recovery indices of both relaxants. The authors concluded that the infusion rate of mivacurium in maintaining muscle relaxation in parturients should be reduced compared to the rate in non-pregnant women and measuring Bolus-T5 may be helpful in determining the infusion rate to maintain muscle relaxation.

Keyword

Neuromuscular block; mivacurium; atracurium; cesarean section; plasma cholinesterase

MeSH Terms

Adult
Atracurium/therapeutic use
Atracurium/administration & dosage*
Cesarean Section*
Comparative Study
Female
Human
Injections, Intramuscular
Isoquinolines/therapeutic use
Isoquinolines/administration & dosage*
Neuromuscular Nondepolarizing Agents/therapeutic use
Neuromuscular Nondepolarizing Agents/administration & dosage*
Pregnancy