Zusammenfassung
Mivacurium (Mivacron) ist ein neues nichtdepolarisierendes Muskelrelaxans aus der Gruppe der Benzylisoquinolindiester. Die aus 3 Stereoisomeren bestehende Verbindung zeichnet sich gegenüber anderen Nichtdepolarisationsblockern v. a. durch eine rasche Metabolisierung durch die Pseudocholinesterase aus [2, 14, 22, 23]. Im Vergleich zu Succinylcholin beträgt die Abbaurate 70–88%. Die durch die hydrolytische Spaltung entstehenden Abbauprodukte - ein Monoester, ein quaternärer Alkohol und eine Dicarboxylsäure - besitzen selbst keinen muskelrelaxierenden Effekt mehr. Sie werden hauptsächlich im Urin und mit der Galle ausgeschieden. Die Clearance ist mit durchschnittlich 55–70 ml/kg KG/min etwa 10 fach größer als die von Atracurium und Vecuronium. Die Eliminationshalbwertszeit der trans-trans (57,4%) und cis-trans (36,2%) Isomere beträgt nur 2–3 min. Das cis-cis Isomer besitzt eine 10 fach geringere muskelrelaxierende Wirkung, hat jedoch eine Eliminationshalbwertszeit von 40–50 min. Da dieses Isomer aber nur zu 6,4% vorliegt, hat dies keinen klinisch relevanten Einfluß auf die Wirkungsdauer [7, 14].
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Hofmockel, R., Pohl, B., Benad, G. (1998). Mivacurium im Kindesalter. In: Funk, W., Hollnberger, H. (eds) Neue Pharmaka und Techniken in der Kinderanästhesie. Kinderanästhesie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58791-7_25
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DOI: https://doi.org/10.1007/978-3-642-58791-7_25
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