Value of the monitoring of curarisation during prolonged mivacurium induced neuromuscular block

A case of neuromuscular blockade of about 200 min of duration, in a 9-year-old boy from mivacurium 0.15 mg.kg-1 is reported. The diagnosis was delayed, after onset of the first signs of recovery, due to the lack of monitoring of neuromuscular transmission. The neuromuscular blockade was reversed wit...

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Veröffentlicht in:	Annales françaises d'anesthésie et de réanimation 1995, Vol.14 (6), p.511
Hauptverfasser:	Avargues, P, Cros, A M, Dardel, E, Darriet, M, Biteau, N
Format:	Artikel
Sprache:	fre
Schlagworte:	Anesthesia Recovery Period Butyrylcholinesterase - blood Butyrylcholinesterase - genetics Child Homozygote Humans Isoquinolines - metabolism Isoquinolines - pharmacology Male Mivacurium Monitoring, Intraoperative Muscle Relaxants, Central - therapeutic use Neuromuscular Junction - drug effects Neuromuscular Nondepolarizing Agents - metabolism Neuromuscular Nondepolarizing Agents - pharmacology Tonsillectomy
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Zusammenfassung:	A case of neuromuscular blockade of about 200 min of duration, in a 9-year-old boy from mivacurium 0.15 mg.kg-1 is reported. The diagnosis was delayed, after onset of the first signs of recovery, due to the lack of monitoring of neuromuscular transmission. The neuromuscular blockade was reversed with neostigmine 0.04 mg.kg-1. Complete reversal required fifty minutes. The presence of an abnormal genetic variant of pseudocholinesterases was demonstrated by the measurements of pseudocholinesterase activity and dibucaine number. The importance of monitoring of neuromuscular transmission for diagnosis and treatment of mivacurium-induced neuromuscular blockade is underlined.
ISSN:	0750-7658