Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Neonatal acid-base status following general anesthesia for emergency abdominal delivery with halothane or isoflurane.
To determine whether halothane or isoflurane as anesthesia for emergency abdominal delivery is associated with better fetal acid-base parameters. ⋯ There is no difference in the frequency or severity of acidosis associated with isoflurane or halothane when used for general anesthesia for emergency abdominal delivery of a distressed fetus.
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Review Comparative Study
Clinical pharmacology of mivacurium chloride: a review.
Mivacurium chloride (Mivacron) is a new benzylisoquinolinium choline-like diester neuromuscular blocking drug with an onset of action at equipotent doses that is comparable to atracurium and vecuronium but slower than succinylcholine. Its clinical duration (injection-25% recovery and injection-95% recovery) is twice that of succinylcholine but one-half to one-third that of atracurium and vecuronium. Mivacurium is easy to use as a continuous infusion and when used this way its recovery characteristics are unchanged. ⋯ In these patients and those with acquired deficiencies, mivacurium should not be used. The duration of action in elderly patients is comparable to that in the young, while in prerenal transplant patients, its duration is prolonged by about 50%, and in prehepatic transplant patients, duration of block is increased threefold. Mivacurium possesses the advantages of short duration, unchanged recovery characteristics following infusions (without phase II block or tachyphylaxis), and precise control.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Mivacurium as an alternative to succinylcholine during outpatient laparoscopy.
To compare (1) the adequacy of conditions for tracheal intubation; (2) the onset, depth, clinically effective duration, and recovery profile; and (3) adverse effects associated with mivacurium as an alternative to succinylcholine during general (endotracheal) anesthesia for outpatient laparoscopy. ⋯ Mivacurium 0.15 mg/kg given intravenously provided good to excellent conditions for tracheal intubation in 2 to 3 minutes. This dose provided a clinically effective duration of action of 20 to 25 minutes, and the residual blockade was readily reversible with neostigmine. Mivacurium did not, however, offer any apparent advantage over succinylcholine in this outpatient population.
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With the continued use of alpha-2-adrenergic agonists in anesthetic practice, careful attention should be given to the potential for drug interactions. Based on a review of the basic and applied pharmacology of this class of compound, we have made recommendations for the safe and efficacious use of alpha-2-adrenergic agonists in the clinical setting.
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Comparative Study
Mivacurium infusion during nitrous oxide-isoflurane anesthesia: a comparison with nitrous oxide-opioid anesthesia.
To determine the potentiation of the neuromuscular blockade induced by a titrated infusion of mivacurium in the presence of isoflurane versus a nitrous oxide (N2O)-opioid anesthesia. ⋯ Isoflurane anesthesia reduces the infusion rate of mivacurium required to produce about 95% depression of neuromuscular function.