• Br J Anaesth · Apr 1994

    Case Reports

    Mivacurium chloride and myasthenia gravis.

    • R D Seigne and R P Scott.
    • Department of Anaesthetics, Salisbury District Hospital, Wiltshire.
    • Br J Anaesth. 1994 Apr 1;72(4):468-9.

    AbstractWe describe the successful use of the short-acting, non-depolarizing neuromuscular blocking agent, mivacurium, in a patient with myasthenia gravis taking pyridostigmine 120 mg four times daily. Increased sensitivity to mivacurium was demonstrated using train-of-four monitoring. A dose of 0.5 times the recommended ED95 (3.0 mg) resulted in 93% block of T1. Spontaneous recovery was prolonged with a recovery index (25%-75% T1) of 20.5 min. Residual block was antagonized without difficulty using neostigmine 2.5 mg. We discuss the relationship between plasma cholinesterase, acetylcholinesterase and anticholinesterase drugs.

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