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Korean Journal of Anesthesiology 1996;30(2):198-205.
DOI: https://doi.org/10.4097/kjae.1996.30.2.198   
The Infusion Rate of Mivacurium for Cesarean Section and its Spontaneous Recovery.
Jong Hoon Kim, Eun Kyoung Ahn, Yang Sik Shin, Hee Byun
Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
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.
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.
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).
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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