Neuromuscular blockade

Question 1

ED95

Answer 1

= suppressuion of twitch height by 95% in 50% of individuals

Question 2

Mivacurium, a bisbenzylisoquinolinium

Answer 2

Mivacurium is non depolarising muscle relaxant. Effects last for 10-20 minutes (dose is 0.07 - 0.25mg/kg). Metabolised by plasma cholinesterase to highly water soluble metabolites excreted rapidly in urine. No active metabolites.

May cause histamine release at high doses.

Question 3

Sux myalgia is more common in women.

Answer 3

True.
Common in day case patients (traditionally), and muscular individuals.

Severity of pain not related to strength of muscle fasciculations, or plasma CK/ myoglobin.

Question 4

In NDMBs, which muscles tend to be blocked first?

Answer 4

Small rapidly moving muscles, “central” muscles

Question 5

NDMBs May affect smooth muscles?

Answer 5

No

Question 6

Are NMDBs ionised or unionised at physiological pH?

Answer 6

Highly ionised