Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T22:56:36.786Z Has data issue: false hasContentIssue false
  • English
  • Français

The pharmacodynamics of mivacurium in the rabbit with carbon tetrachloride-induced liver disease

Published online by Cambridge University Press:  01 September 2007

M. A. Cheong ,
K. S. Kim  and
G. S. Lee
M. A. Cheong
Affiliation:
Hanyang University Hospital, Department of Anesthesiology, Seoul, Korea
K. S. Kim*
Affiliation:
Hanyang University Hospital, Department of Anesthesiology, Seoul, Korea
G. S. Lee
Affiliation:
Hanyang University Hospital, Department of Anesthesiology, Seoul, Korea
*
Correspondence to: Kyo Sang Kim, Department of Anesthesiology, Hanyang University Hospital, #17 Haengdang dong, Sungdong gu, Seoul 133-792, Korea. E-mail: [email protected]; Tel: +82 2 2290 8680; Fax: +82 2 2299 0742
Get access

Summary

Background and objective

Neuromuscular blocking effects according to the severity of liver dysfunction have not been evaluated. We assessed the neuromuscular effects of mivacurium in carbon tetrachloride (CCl4)-treated rabbits with toxic hepatitis in vivo.

Methods

We compared the dose–response relationships and the neuromuscular blocking effects of mivacurium in 66 rabbits randomly treated with 0.3 mL kg−1 of corn oil, 0.3 mL kg−1 of CCl4 or 0.6 mL kg−1 of CCl4 for 11 weeks, respectively. Train-of-four stimuli were applied every 10 s to the common peroneal nerve and the force of contraction of the tibialis anterior muscle was measured.

Results

Severe hepatitis was associated with a rightward shift of the mivacurium dose–response curves, but mild hepatitis had no effect. The calculated ED50 values for the control, mild and severe hepatitis were 17.1 ± 2.6, 18.2 ± 2.7 and 31.8 ± 3.2 μg kg−1, respectively. Rabbits with severe hepatitis had a significantly prolonged recovery time from neuromuscular blockade compared with other rabbits. Cholinesterase activity had a negative correlation with recovery indices of mivacurium even in severe hepatic injury. Severe hepatitis induced a prolongation of action duration of repeated doses, but maintained the constant intervals.

Conclusions

The dose–response and the time course of neuromuscular blockade of mivacurium differ in mild hepatitis compared with severe hepatitis, but required no adjustments of different doses for repeated injection after the desired depth of neuromuscular block, and had a negative correlation with the activity of plasma cholinesterase in both hepatic injuries.

Keywords

NEUROMUSCULAR BLOCKING AGENTS, mivacuriumLIVER DISEASES, toxic hepatitisTOXIC AGENTS, carbon tetrachlorideRABBITS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 9 , September 2007 , pp. 789 - 795
Copyright
Copyright © European Society of Anaesthesiology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Savarese, JJ, Ali, HH, Basta, SJ et al. . The clinical neuromuscular pharmacology of mivacurium chloride BW (B1090U). A short-acting nondepolarizing ester neuromuscular blocking drug. Anesthesiology 1988; 68: 723–732.CrossRefGoogle ScholarPubMed
2.Rigg, JD, Wilson, AC, Pollard, BJ. Mivacurium or vecuronium for muscular relaxation in day-case surgery. Eur J Anaesthesiol 1997; 14: 630–634.CrossRefGoogle ScholarPubMed
3.Cook, DR, Freeman, JA, Lai, AA et al. . Pharmacokinetics of mivacurium in normal patients and in those with hepatic or renal failure. Br J Anaesth 1992; 69: 580–585.CrossRefGoogle ScholarPubMed
4.Devlin, JC, Head-Rapson, AG, Parker, CJ, Hunter, JM. Pharmacodynamics of mivacurium chloride in patients with hepatic cirrhosis. Br J Anaesth 1993; 71: 227–231.CrossRefGoogle ScholarPubMed
5.Ostergaard, D, Jensen, FS, Jensen, E, Skovgaard, LT, Viby-Mogensen, J. Influence of plasma cholinesterase activity on recovery from mivacurium-induced neuromuscular blockade in phenotypically normal patients. Acta Anaesthesiol Scand 1992; 36: 702–706.CrossRefGoogle ScholarPubMed
6.Phillips, BJ, Hunter, JM. Use of mivacurium chloride by constant infusion in the anephric patient. Br J Anaesth 1992; 68: 492–498.CrossRefGoogle ScholarPubMed
7.Muriel, P, Moreno, MG, Hernandez, MC, Chavez, E, Alcantar, LK. Resolution of liver fibrosis in chronic CCl4 administration in the rat after discontinuation of treatment: effect of silymarin, silibinin, colchicine and trimethylcolchicinic acid. Basic Clin Pharmacol Toxicol 2005; 96: 375–380.CrossRefGoogle ScholarPubMed
8.Kamalakkannan, N, Rukkumani, R, Varma, PS, Viswanathan, P, Rajasekharan, KN, Menon, VP. Comparative effects of curcumin and an analogue of curcumin in carbon tetrachloride-induced hepatotoxicity in rats. Basic Clin Pharmacol Toxicol 2005; 97: 15–21.CrossRefGoogle Scholar
9.Jin, B, Alter, HJ, Zhang, ZC et al. . Reversibility of experimental rabbit liver cirrhosis by portal collagenase administration. Lab Invest 2005; 85: 992–1002.CrossRefGoogle ScholarPubMed
10.Garry, PJ. A manual and automated procedure for measuring serum cholinesterase activity and identifying enzyme variants. Differentiation by means of Tris and phosphate buffers. Clin Chem 1971; 17: 192–198.CrossRefGoogle ScholarPubMed
11.Gronbaek, K, Christensen, PB, Hamilton-Dutoit, S et al. . Interobserver variation in interpretation of serial liver biopsies from patients with chronic hepatitis C. J Viral Hepat 2002; 9: 443–449.CrossRefGoogle ScholarPubMed
12.Lee, YS, Yoon, SK, Chung, ES et al. . The relationship of histologic activity to serum ALT, HCV genotype and HCV RNA titers in chronic hepatitis C. J Korean Med Sci 2001; 16: 585–591.CrossRefGoogle ScholarPubMed
13.Stowell, RE, Lee, CS, Tsuboi, KK, Villasana, A. Histochemical and microchemical changes in experimental cirrhosis and hepatoma formation in mice by carbon tetrachloride. Cancer Res 1951; 11: 345–354.Google ScholarPubMed
14.Brandao, CG, Ferreira, HH, Piovesana, H et al. . Development of an experimental model of liver cirrhosis in rabbits. Clin Exp Pharmacol Physiol 2000; 27: 987–990.CrossRefGoogle ScholarPubMed
15.Ugazio, G, Bosia, S, Cornaglia, E. Experimental model of cirrhosis in rabbits exposed to carbon tetrachloride by inhalation. Exp Commun Mol Pathol Pharmacol 1995; 88: 63–77.Google ScholarPubMed
16.Kim, KS, Jeon, JW, Koh, MS, Shim, JH, Cho, SY, Suh, JK. The duration of immobilization causes the changing pharmacodynamics of mivacurium and rocuronium in rabbits. Anesth Analg 2003; 96: 438–442.CrossRefGoogle ScholarPubMed
17.Mayer, B, Fink, H, Bogdanski, R, Stadler, J, Blobner, M. Inflammatory liver disease shortens atracurium-induced neuromuscular blockade in rats. Eur J Anaesthesiol 2001; 18: 599–604.CrossRefGoogle ScholarPubMed
18.Duvaldestin, P, Agoston, S, Henzel, D, Kersten, UW, Desmonts, JM. Pancuronium pharmacokinetics in patients with liver cirrhosis. Br J Anaesth 1978; 50: 1131–1136.CrossRefGoogle ScholarPubMed
19.Liu, H, Gaskari, SA, Lee, SS. Cardiac and vascular changes in cirrhosis: pathogenic mechanisms. World J Gastroenterol 2006; 12: 837–842.CrossRefGoogle ScholarPubMed
20.Audibert, G, Donati, F. The onset of rocuronium, but not of vecuronium or mivacurium, is modified by tourniquet inflation. Anesth Analg 1996; 82: 848–853.Google ScholarPubMed
21.Green, DW, Fisher, M, Sockalingham, I. Mivacurium compared with succinylcholine in children with liver disease. Br J Anaesth 1998; 81: 463–465.CrossRefGoogle ScholarPubMed
22.Ostergaard, D, Jensen, FS, Skovgaard, LT, Viby-Mogensen, J. Dose-response relationship for mivacurium in patients with phenotypically abnormal plasma cholinesterase activity. Acta Anaesthesiol Scand 1995; 39: 1016–1018.CrossRefGoogle ScholarPubMed
23.Kim, KS, Kim, KH, Shin, WJ, Yoo, HK. Neuromuscular interaction between mivacurium and esmolol in rabbits. Anaesthesia 1998; 53: 140–145.CrossRefGoogle ScholarPubMed
24.Blanloeil, Y, Delaroche, O. Decrease in plasmatic cholinesterase activity in severe bacterial infections: comparison with the decrease observed in severe liver cirrhosis. Ann Fr Anesth Reanim 1996; 15: 220–222.Google ScholarPubMed
25.Wanless, IR, Belgiorno, J, Huet, PM. Hepatic sinusoidal fibrosis induced by cholesterol and stilbestrol in the rabbit: 1. Morphology and inhibition of fibrogenesis by dipyridamole. Hepatology 1996; 24: 855–864.CrossRefGoogle ScholarPubMed
26.Arroyo, V, Jimenez, W. Complications of cirrhosis. II. Renal and circulatory dysfunction. Lights and shadows in an important clinical problem. J Hepatol 2000; 32: 157–170.CrossRefGoogle Scholar