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Korean J Anesthesiol > Volume 40(2); 2001 > Article
Korean Journal of Anesthesiology 2001;40(2):163-168.
DOI: https://doi.org/10.4097/kjae.2001.40.2.163   
Interaction between Mivacurium and Nitroglycerin.
In Su Han, Jae Chol Shim, Jeong Woo Jeon, Jun Ro Yun, Chang Soo Hong, Jang Hyuk Mun, Ho Sik Mun, Chul Woo Lee
1Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
2Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea.
Abstract
BACKGROUND
The neuromuscular blocking effects of a nondepolarizing neuromuscular blocker (NDNM) during a nitroglycerin (NTG) infusion were significantly potentiated and prolonged. NTG reduced the requirement of a NDNM in surgical patients. We investigated the influence of a NTG single bolus injection on a mivacurium nuromuscular blockade.
METHODS
We studied 36 adult surgical patients, ASA physical status I or II, between 15 and 53 years old. Neuromuscular monitoring was measured by TOF-GUARD (Biometer Co., Denmark). Anesthesia was induced by thiopental sodium 3-5 mg/kg and fentanyl 3 microgram/kg, and maintained with 3 L/min N2O, 2 L/min O2 and 1 vol.% isoflurane. Patients were randomly assigned to 3 groups: 1) Control group (mivacurium 0.16 mg/kg), 2) N100 group (mivacurium 0.16 mg/kg, NTG 100 microgram), 3) N200 group (mivacurium 0.16 mg/kg, NTG 200 microgram). We measured the train-of-four (TOF) response from the beginning of recovery to the complete regaining of muscle twitch.
RESULTS
NTG produced a prolongation of the neuromuscular blocking effect by mivacurium. T1 (contro group: 12.1 +/- 0.5, N100 group: 15.8 +/- 0.4 and N200 group: 11.6 +/- 0.4 min), T25 (16.4 +/- 0.4, 20.5 +/- 0.5 and 14.9 +/- 1.0 min), T75 (22.5 +/- 0.9, 29.4 +/- 0.7 and 20.1 +/- 1.0 min), T95 (27.3 +/- 0.6, 39.6 +/- 0.7 and 24.6 +/- 1.5 min) and the recovery index (6.1 +/- 0.6, 9.0 +/- 0.4 and 5.3 +/- 0.7 min) were significantly prolonged in the N100 and N200 groups (P < 0.05).
CONCLUSION
These results suggest that a NTG bolus injection prolonged the neuromuscular blocking effect of mivacurium, dose relatively.
Key Words: Interactions, drug: mivacurium; nitroglycerine; Monitoring: train-of-four; Neuromuscular relaxants: mivacurium
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