Vecuronium or Pancuronium as a Priming Agent is Effective to Shorten the Onset of  Mivacurium-Induced Neuromuscular Block for Endotracheal Intubation.

Lee,  Soo Kyung; Han,  Jeong Uk; Lee,  Sang Yeol; Ma,  Eun Joo; Shin,  Yang Sik

doi:1997.32.6.946

Clinical Research Article

Korean Journal of Anesthesiology 1997;32(6):946-952.
DOI: https://doi.org/10.4097/kjae.1997.32.6.946

Vecuronium or Pancuronium as a Priming Agent is Effective to Shorten the Onset of Mivacurium-Induced Neuromuscular Block for Endotracheal Intubation.

Soo Kyung Lee, Jeong Uk Han, Sang Yeol Lee, Eun Joo Ma, Yang Sik Shin

¹Department of Anesthesiology, College of Medicine, Yonsei University, Seoul, Korea.
²Department of Anesthesiology, College of Medicine, Inha University, Incheon, Korea.
³Department of Anesthesiology, College of Medicine, Aju University, Suwon, Korea.
⁴Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.

Abstract

BACKGROUND
Mivacurium is a non-depolarizing neuromuscular blocking agent which has short duration of action. The goal of this study was to describe a technique which could shorten the onset time of mivacurium for rapid endotracheal intubation by using priming principle.
METHODS
Thirty-one patients were randomly allocated into four groups. Patients in group I(n=8) received a single dose of 0.12 mg/kg mivacurium. Those in group II(n=10), III(n=6), and IV(n=7) received 0.015 mg/kg pancuronium, 0.012 mg/kg vecuronium, and 0.008 mg/kg mivacurium 4 minutes before the intubating dose of 0.12 mg/kg mivacurium was given respectively. Accelerographic response to train-of-four(TOF) stimulation of ulnar nerve at 15 seconds interval was used for neuromuscular monitoring. The onset time, the duration and recovery indices were compared between groups.
RESULTS
The onset time in group II (2.9 0.49 min) and III (2.33 0.4 min) were significantly faster than that in group I (5.19 0.47 min). In the group II, the duration (26.3 1.9 min) and recovery index (12.35 2.45 min) were significantly prolonged than those in group I (9.12 1.21 and 4.75 0.52 min), respectively.
CONCLUSION
The onset time is more rapid when pancuronium or vecuronium is used as priming agent than when mivacurium as single bolus injection or priming agent.

Key Words: Neuromuscular relaxants; mivacurium; vecuronium; pancuronium; Pharmacology; onset time; priming principle