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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 1999 March;65(3):81-5

language: English

Mivacurium in ­patients ­with intra­cra­ni­al pathol­o­gy

Cafiero T. 1, Razzino S. 1, Mastronardi P. 2, Mazzarella B. 2, De Vivo P. 3

1 Anesthesia and Resuscitation Service, San Rocco Hospital, ASL CE/2, Sessa Aurunca (Caserta);
2 Department of Anesthesia and Resuscitation, University of Naples “Federico II”, Naples ;
3 2nd Service of Anesthesia and Resuscitation, “Casa Sollievo del­la Sofferenza” Hospital, San Giovanni Rotondo (Foggia)


Background. The aim of ­this ­study was to eval­u­ate the ­effects of miv­a­cu­ri­um on the cere­bro­spi­nal ­fluid pres­sure (­CSFP) in ­patients requir­ing mus­cle relax­a­tion to facil­i­tate mechan­i­cal ven­ti­la­tion and on the intra­cra­ni­al pres­sure (ICP) in ­patients under­go­ing neu­ro­sur­gery.
Methods. Experimental ­design: pros­pec­tive ­study. Setting: ICU in a hos­pi­tal and oper­at­ing ­room in a neu­ro­sur­gery depart­ment at University. Patients: 12 ­patients, GCS 6-7, ­with a ­mean age of 62.6±6.2 ­were stud­ied in ICU and 10 ­patients, ASA I-II, ­with a ­mean age of 58.6±6.4 ­were stud­ied in the oper­at­ing ­room. Interven-­tions: all ­patients ­received miv­a­cu­ri­um as sin­gle ­bolus ­dose of 0.2 mg/kg iv. Measurements: Heart ­rate, SAP, DAP and MAP ­were record­ed at dif­fer­ent ­times. In ICU ­CSFP was meas­ured via a cath­e­ter in lum­bar sub­arach­noid ­space and in oper­at­ing ­room ICP was meas­ured via an intra­ven­tric­u­lar cath­e­ter. CPP was eval­u­at­ed as the dif­fer­ence ­between MAP and ICP. Statistical anal­y­sis was car­ried out ­using ANO­VA for repeat­ed meas­ures and Bonferroni “t”- ­test and a val­ue of p<0.05 was con­sid­ered to be sig­nif­i­cant.
Results. Mivacurium was ­found not to influ­ence or to ­increase ICP or ­CSFP. No sig­nif­i­cant chang­es in car­di­o­cir­cu­la­to­ry param­e­ters ­were record­ed in all ­patients.
Conclusions. In con­clu­sion, miv­a­cu­ri­um can be con­sid­ered a suit­able and man­age­able neu­ro­mus­cu­lar block­ing ­drug in the man­age­ment of ­patients ­with intra­cra­ni­al pathol­o­gy.

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