CMT children: Onset and duration of mivacurium-induced neuromuscular blockade

[Guest guest]

Paediatr Anaesth. 2006 Feb;16(2):182-7.

Onset and duration of mivacurium-induced neuromuscular blockade in

children with Charcot-Marie-Tooth disease. A case series with five

children.

Schmitt HJ, Wick S, Munster T.

Department of Anaesthesiology, The Department is part of the

Friedrich- University Erlangen-Nuremberg, Erlangen, Germany.

Summary Background: The Charcot-Marie-Tooth (CMT) disorders are a

group of hereditary motor and sensory neuropathies characterized

clinically by peripheral muscle wasting and weakness. We hypothesized

that unknown involvement of the muscle used for monitoring

neuromuscular block may account for the conflicting reports about the

effect of nondepolarizing neuromuscular agents in these patients. The

aim of this study was to compare onset and recovery from mivacurium-

induced neuromuscular block on the adductor pollicis and orbicularis

oculi muscles.

Methods: We used mivacurium 0.2 mg.kg(-1) in five children (aged 7-12

years) with CMT type I undergoing propofol-fentanyl-oxygen-air

anesthesia for orthopedic surgery. Using acceleromyography,

neuromuscular transmission was monitored in parallel in the eye and

thumb muscles, and onset and duration times were recorded.

Results: Following bolus administration of 0.2 mg.kg(-1) of

mivacurium the onset time ranged between 135 and 240 s and 75 and 165

s in the eye and in the thumb, respectively. The recovery time varied

between 5.3 and 16 min and 6 and 31.3 min in the eye and in the

thumb, respectively.

Conclusions: In our small series of patients with CMT the clinical

duration of mivacurium-induced neuromuscular block was similar to

data known from children without neuromuscular disease.