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Equi-lasting doses of rocuronium, compared to mivacurium, result in improved neuromuscular blockade in patients undergoing gynecological laparoscopy

Des doses de durée équivalente de rocuronium, comparé au mivacurium, améliorent la curarisation chez des patientes qui subissent une laparoscopie gynécologique

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To compare equi-lasting doses of a short-acting (mivacurium) to an intermediate-acting (rocuronium) neuromuscular relaxant, with regard to intubating conditions, efficacy, number of maintenance doses, hemodynamic alterations, adverse events and costs, in patients undergoing laparoscopic gynecological surgery.


Sixty patients were randomly allocated to receive either 0.2 mg·kg−1 (3 × ED95) mivacurium or 0.5 mg·kg−1 (1.7 × ED95) rocuronium, under propofol/fentanyl anesthesia. TI, first twitch of the train-of-four (TOF) and TOF ratio (T4:TI) were used to evaluate neuromuscular block using the Relaxometer® mechanomyograph. The trachea was intubated when TI was maximally suppressed. Neuromuscular block was maintained at 25% TI with equi-lasting doses of 0.075 mg·kg−1 mivacurium or 0. 15 mg·kg−1 rocuronium.


Mean (min) ± SD mivacurium onset time (1.9 ± 0.4) was longer than that of rocuronium (1.3 ± 0.3). This did not yield a statistical difference in intubating conditions between the two groups. Interval 25–75% TI recovery and time to 0.8 TOF recovery were prolonged following rocuronium (11.9 ± 3.9, 52.6 ± 15.5 respectively) compared to mivacurium (6.7 ± 2.3, 39.2 ± 8. 1 respectively). More patients, 22/30, required mivacurium maintenance doses compared to 14/30 patients in the rocuronium group. Arterial blood pressure declined and 13/30 patients manifested erythema following mivacurium administration. The acquisition costs of rocuronium (6.93 Euro/patient) were 23% lower compared to mivacurium (8.96 Euro/patient).


Equi-lasting doses of rocuronium resulted in favourable intubating conditions more rapidly, improved hemodynamic stability, required less frequent administration of maintenance doses and were not associated with erythema, compared to mivacurium.



Comparer des doses de durée équivalente d’un myorelaxant à action brève, le mivacurium à celles d’un myorelaxant à effet intermédiaire, le rocuronium, quant aux conditions de l’intubation, l’efficacité, le nombre de doses de maintien, les changements hémodynamiques, les incidents et le coût, chez des patientes qui subissent une laparoscopie gynécologique.


Soixante patientes ont été réparties au hasard et ont reçu, soit 0,2 mg·kg−1 (3 × ED95) de mivacurium, soit 0,5 mg·kg−1 (1,7 × ED95) de rocuronium, sous une anesthésie au propofol et au fentanyl. TI, première stimulation d’un train-de-quatre (TDQ) et le ratio du TDQ (T4: TI) ont permis d’évaluer la curarisation avec un relaxomécanomyographe. L’intubation a été réalisée après la suppression maximale de TI. La curarisation a été maintenue à 25 % de TI par des doses de durée équivalente de 0,075 mg·kg−1 de mivacurium ou de 0,15 mg·kg−1 de rocuronium.


Le délai d’installation moyen (min) [± l’écart type] du mivacurium (1,9 ± 0,4) a été plus long que celui du rocuronium (1,3 ± 0,3). Ce résultat ne fournit pas de différence statistique intergroupe. La récupération dans l’intervalle 25–75 % TI et le temps nécessaire à la récupération à 0,8 du TDQ se sont prolongés avec le rocuronium (11,9 ± 3,9, 52,6 ± 15,5 respectivement) comparé au mivacurium (6,7 ± 2,3, 39,2 ± 8,1 respectivement). Un plus grand nombre de patientes, 22/30, ont eu besoin de doses de maintien de mivacurium, comparativement à 14/30 patientes ayant reçu du rocuronium. La tension artérielle a baissé et 13/30 patientes ontmanifesté de l’érythème à la suite de l’administration de mivacurium. Le coût d’achat du rocuronium (6,93 Euros/patiente) a été de 23 % plus bas que celui du mivacurium (8,96 Euros/patiente).


Des doses de durée équivalente de rocuronium, comparé au mivacurium, ont permis une intubation plus précoce, amélioré la stabilité hémodynamique, exigé des doses de maintien moins fréquentes et n’ont pas été associées à un érythème.


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Correspondence to Ashraf A. Dahaba.

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Dahaba, A.A., Schweitzer, E., Fitzgerald, R.D. et al. Equi-lasting doses of rocuronium, compared to mivacurium, result in improved neuromuscular blockade in patients undergoing gynecological laparoscopy. Can J Anesth 48, 1084–1090 (2001). https://doi.org/10.1007/BF03020374

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  • Rocuronium
  • Neuromuscular Blockade
  • Neuromuscular Block
  • Mivacurium
  • Adductor Pollicis