mivacurium and Myotonic-Dystrophy

Mivacurium is a short-acting non-deplolarizing neuromuscular blocking agent. Its use in an obese patient with myotonic dystrophy undergoing laparoscopic cholecystectomy is reported. Mivacurium was used as a bolus dose of 0.07 mg. kg-1, followed by a continuous infusion at the rate of 0.003 mg. kg-1. min-1. Muscle relaxation, monitored by a train of four count, was adequate throughout the surgery. Spontaneous recovery of the neuromuscular function was obtained fifteen minutes after the end of mivacurium infusion. Neostigmine was not given. Postoperative mechanical ventilation and respiratory complications were avoided.

Topics: Anesthesia; Cholecystectomy; Female; Humans; Isoquinolines; Laparoscopy; Middle Aged; Mivacurium; Myotonic Dystrophy; Neuromuscular Nondepolarizing Agents; Obesity; Respiratory Function Tests

We describe the successful use of the short-acting, non-depolarizing neuromuscular blocking agent, mivacurium, in a patient with myotonic dystrophy. Increased sensitivity to mivacurium was demonstrated using train-of-four monitoring, with a single dose of mivacurium providing adequate block for 90 min of surgery. Spontaneous recovery appeared prolonged with a recovery index (25-75% T1) of 10 min and a recovery time (5-95% T1) of 30 min. The use of reversal agents and anticholinergic agents was avoided.

Topics: Adult; Humans; Isoquinolines; Male; Mivacurium; Myotonic Dystrophy; Nerve Block; Neuromuscular Junction; Neuromuscular Nondepolarizing Agents; Time Factors

Topics: Cystoscopy; Humans; Isoquinolines; Male; Middle Aged; Mivacurium; Myotonic Dystrophy; Neuromuscular Nondepolarizing Agents