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A comparison of intubation conditions and time-course of action with rocuronium and mivacurium for day case anaesthesia

Published online by Cambridge University Press:  01 June 2007

P. E. Pendeville*
Affiliation:
Cliniques Universitaires Saint-Luc, UCL Medical School, Department of Anaesthesiology, Brussels, Belgium
F. Lois
Affiliation:
Cliniques Universitaires Saint-Luc, UCL Medical School, Department of Anaesthesiology, Brussels, Belgium
J.-L. Scholtes
Affiliation:
Cliniques Universitaires Saint-Luc, UCL Medical School, Department of Anaesthesiology, Brussels, Belgium
*
Correspondence to: Philippe Pendeville, Department of Anaesthesiology, Saint-Luc University Hospital, Avenue Hippocrate 10/1821, 1200 Brussels, Belgium. E-mail: [email protected]; Tel: +32 2764 1821; Fax: +32 2764 3699
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Summary

Background and objective

To compare intubation conditions and time-course of action of rocuronium and mivacurium for day case anaesthesia.

Methods

Fifty ASA I or II patients were enrolled. Anaesthesia was induced with propofol using a target controlled infusion system (target 6–8 μg mL−1) and sufentanil (0.25 μg kg−1). It was maintained with propofol (target 3.5–4.5 μg mL−1) and 50% nitrous oxide in oxygen. Muscle relaxation was achieved with either mivacurium (0.15 mg kg−1) or rocuronium (0.3 mg kg−1). Neuromuscular transmission was monitored and recorded continuously by acceleromyography using a TOF-WATCH SX (Biometer™/; Denmark) with supramaximal train-of-four stimulation of the ulnar nerve. Tracheal intubation was carried out by an experienced anaesthetist blinded to the type of the muscle relaxant. Intubation conditions were evaluated according to a standard scheme (ease of laryngoscopy, position of vocal cords, airway reaction and limb movements).

Results

Intubation conditions were good or excellent for both mivacurium 0.15 mg kg−1 (good = 8%; excellent = 92%) and rocuronium 0.3 mg kg−1 (excellent = 100%). Times to maximum blockade and clinical duration were not different.

Conclusions

There is no significant difference between mivacurium and rocuronium concerning the onset and the recovery of muscle relaxation. Rocuronium is an alternative to mivacurium for short procedures, without the risk of unexpected prolonged relaxation due to a possible defect in plasma cholinesterase.

Type
Original Article
Copyright
Copyright © European Society of Anaesthesiology 2007

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