| The Infusion Rate of Mivacurium for Cesarean Section and its Spontaneous Recovery. |
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Jong Hoon Kim, Eun Kyoung Ahn, Yang Sik Shin, Hee Byun |
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Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea. |
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| Abstract |
BACKGROUND
Mivacurium is a nondepolarizing muscle relaxant and metabolized by pseudo-cholinesterase(pChe). Many reports show fall in pChe activity during pregnancy, so the metabolism of mivacurium may be delayed and muscle relaxation would be prolonged.
METHODS
Muscle relaxation of full-term pregnant women(C group, n=10) and nopregnant women(Non-C group, n=10) was maintained by continuous infusion of mivacurium to keep 1st response of TOF at 5+/-1%. After discontinuance of infusion, recovery profiles were measured with accelerography.
RESULTS
The Infusion rate of mivacurium to maintain 1st twich response of TOF at 5+/-1% was significantly low in C group comparing with Non-C group(P<0.05). There was no significant difference in pChe activity between two groups.
There was no significant difference in recovery index, recovery time(T1 25%-T4 ratio, 0.75). There was a little correlation between the total infusion time and recovery profiles(recovery index: r2=0.37, recovery time: r2=0.28).
Strong correlation existed between bolus-TS(time interval from the injection of mivacurium to recovery of 5% twitch hight) and infusion rate(r2=0.76).
CONCLUSION
The mivacurium infusion rate of C group to maintain muscle relaxation was significantly lower than Non-C group. There would be many possible reasons including over-estimation of paturient body weight compared with lean body mass, decrease of blood volume due to hemorrhage. |
| Key Words:
Enzymes; pseudocholinesterase; Neuromuscular relaxants; mivacurium; Surgery; obstetrics |
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