제왕절개술을 위한 Mivacurium 의 점적주입속도와 근이완에서의 자연회복

• Published in: Korean journal of anesthesiology Vol. 30; no. 2; pp. 198 - 205
• Main Authors: 김종훈, Jong Hoon Kim, 신양식, Yang Sik Shin, 안은경, Eun Kyoung Ahn, 변희, Hee Byun
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 28.02.1996
• Subjects: Enzymes; mivacurium. Surgery; obstetrics; pseudocholinesterase. Neuromuscular relaxants
• ISSN: 2005-6419; 2005-7563

Background: Mivacurium is a nondepolarizing muscle relaxant and metabolized by pseudo-cholinesterase(pChe). Many reports show fall in pChe activity during pregnancy, so the metabolism of mivacurium may be delayed and muscle relaxation would be prolonged. Methods: Muscle relaxation of full-term pregnant women(C group, n=10) and nopregnant women(Non-C group, n=10) was maintained by continuous infusion of mivacurium to keep 1st response of TOF at 5±1%. After discontinuance of infusion, recovery profiles were measured with accelerography. Results: The Infusion rate of mivacurium to maintain 1st twich response of TOF at 5±1% was significantly low in C group comparing with Non-C group(P<0.05). There was no significant difference in pChe activity between two groups. There was no significant difference in recovery index, recovery time(T1 25%-T4 ratio, 0.75). There was a little correlation between the total infusion time and recovery profiles(recovery index: r(2)=0.37, recovery time: r(2)=0.28). Strong correlation existed between bolus-TS(time interval from the injection of mivacurium to recovery of 5% twitch hight) and infusion rate(r(2)=0.76). Conclusion: The mivacurium infusion rate of C group to maintain muscle relaxation was significantly lower than Non-C group. There would be many possible reasons including over-estimation of paturient body weight compared with lean body mass, decrease of blood volume due to hemorrhage.(Korean J Anesthesiol 1996; 30: 198~205)