Mivacurium: a Review

Mivacurium: a Review Purpose of Review Mivacurium is a short-acting non-depolarizing neuromuscular-blocking agent (NMBA) which has recently been re-released onto the US market. This review provides a brief overview about the pharmacology of mivacurium and discusses its use in recent clinical practice. Recent Findings Mivacurium has been reported to be especially useful in the pediatric population, especially for shorter cases, and infusions can be used for longer cases without inducing tachyphylaxis. As it is rapidly metabolized by pseudocholinesterase (PChE), mivacurium does usually not require a specific reversal agent to offset its actions at the end of surgery. Especially for use in short cases, this makes it a potentially advantageous alternative to the use of other NMBA. However, deficiencies in PChE as well as old age and some drug interactions can be associated with prolonged neuromuscular blockade. The rapid administration of higher doses may provoke significant histamine release leading to hemodynamic compromise. Summary Despite other NMBA being available on the market and its side effects, mivacurium may still be a useful agent in short cases, particularly in the pediatric population. . . . . Keywords Mivacurium Neuromuscular-blocking agent Pseudocholinesterase deficiency Cardiovascular instability Drug interactions Introduction been re-released in the USA after previous discontinuation http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Anesthesiology Reports Springer Journals

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Anesthesiology; Intensive / Critical Care Medicine; Internal Medicine
eISSN
2167-6275
D.O.I.
10.1007/s40140-018-0264-7
Publisher site
See Article on Publisher Site

Abstract

Purpose of Review Mivacurium is a short-acting non-depolarizing neuromuscular-blocking agent (NMBA) which has recently been re-released onto the US market. This review provides a brief overview about the pharmacology of mivacurium and discusses its use in recent clinical practice. Recent Findings Mivacurium has been reported to be especially useful in the pediatric population, especially for shorter cases, and infusions can be used for longer cases without inducing tachyphylaxis. As it is rapidly metabolized by pseudocholinesterase (PChE), mivacurium does usually not require a specific reversal agent to offset its actions at the end of surgery. Especially for use in short cases, this makes it a potentially advantageous alternative to the use of other NMBA. However, deficiencies in PChE as well as old age and some drug interactions can be associated with prolonged neuromuscular blockade. The rapid administration of higher doses may provoke significant histamine release leading to hemodynamic compromise. Summary Despite other NMBA being available on the market and its side effects, mivacurium may still be a useful agent in short cases, particularly in the pediatric population. . . . . Keywords Mivacurium Neuromuscular-blocking agent Pseudocholinesterase deficiency Cardiovascular instability Drug interactions Introduction been re-released in the USA after previous discontinuation

Journal

Current Anesthesiology ReportsSpringer Journals

Published: Mar 22, 2018

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