Do metoclopramide and ondansetrone alter mivacurium-induced
               neuromuscular blockade? - a randomised trial

Tercan, Mehmet; Efe, Esra Mercanoglu; Turker, Gurkan; Kaya, Fatma Nur; Yavascaoglu, Belgin; Ozarda, Yesim; Mogol, Elif Basagan

doi:10.1016/j.bjan.2013.04.007

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Revista Brasileira de Anestesiologia

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Scientific Article • Rev. Bras. Anestesiol. 64 (1) • Jan-Feb 2014 • https://doi.org/10.1016/j.bjan.2013.04.007 copy

Do metoclopramide and ondansetrone alter mivacurium-induced neuromuscular blockade? - a randomised trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

Background:

We aimed to investigate the effects of metoclopramide and ondansetrone on mivacurium neuromuscular blockade.

Methods:

Seventy five, ASA I-II patients, aged 18-65 and scheduled for elective surgery requiring tracheal intubation were included in the study. The patients received metoclopramide 10 mg, ondansetrone 4 mg or normal saline 5 mL; group M, group O, group NS (n = 25), respectively. Before anesthesia study drugs were administered in a volume of 5 mL. The level of plasma cholinesterase were obtained before and 5 minutes after the administration of study drugs and5 minutes after the administration of mivacurium. Onset time, T25, T75, T25-75, T90 levelswere compared with each other and differences between each patients were investigated. After recording T90, the study was terminated and surgery was started.

Results:

Onset time was significantly shorter in group M, than the other two groups. Onset time in group O was significantly shorter than in group NS. In Group M T25, T75, T90 and recovery indices were significantly greater than in Group NS (p < 0.001). In Group O T25, T75 were greater than Group NS (p < 0.01 and p < 0.05, respectively). In Group M T75, T90 and emergence indices were significantly higher than Group O (p < 0.001, p < 0.01, p < 0.001, respectively). In Groups M and O, plasma cholinesterase levels decreased significantly (p < 0.001) after administration of study drugs and mivacurium. Plasma cholinesterase also was reduced in Group NS 5 minutes after the administration of mivacurium (p < 0.001).

Conclusion:

Ondansetrone is believed to be more reliable agent than metoclopramide when used with mivacurium.

Mivacurium; Metoclopramide; Ondansetrone; Neuromusculary; Blockade; Anesthesia

	Group M	Group O	Group SN
	n = 25	n = 25	n = 25
Gender (M/F)	4/21	5/20	4/21
ASA (I/II)	18/7	20/5	22/3
Age (year)	44.24 ± 10.38	33.52 ± 10.57	41.32 ± 12.24
Weight (kg)	66.16 ± 9.46	68.08 ± 9.61	65.48 ± 8.52
Height (cm)	163.84 ± 5.41	166.36 ± 7.33	162.92 ± 5.6
BMI	24.60 ± 2.96	24.50 ± 2.00	24.60 ± 2.36

	EMAX	Onset time (sec)
Group M	99.6 ± 0.48	138.8 ± 5.82^a
Group O	99.4 ± 0.50	162.0 ± 9.89^b
Group SF	99.3 ± 0.47	168.8 ± 7.67

	^T25	^T75	^T90	Recovery index
Group M	20.92 ± 1.70^a a p < 0,001; comparing with Group SN.	27.92 ± 1.75^a a p < 0,001; comparing with Group SN. ^,^b b p < 0,001; comparing with Group O.	33.40 ± 1.77^a a p < 0,001; comparing with Group SN. ^,^c c p < 0,01; comparing with Group O.	7.00 ± 0.70^a a p < 0,001; comparing with Group SN. ^,^b b p < 0,001; comparing with Group O.
Group O	19.80 ± 2.12^d d p < 0,01; comparing with Group SN.	25.04 ±2.38^e e p < 0,05; comparing with Group SN.	30.44 ± 2.88	5.48 ± 0.87
Group SN	17.56 ± 2.45	23.12 ± 2.83	29.72 ± 3.03	5.24 ± 0.87

	PC1	PC2	PC3
Group M	6.502 ± 0.922	5.674 ± 0.817^a a p < 0.001 evaluation in group.	5.033 ± 0.790^a a p < 0.001 evaluation in group.
Group O	6.124 ± 1.418	5.634 ± 1.387^a a p < 0.001 evaluation in group.	4.884 ± 1.203^a a p < 0.001 evaluation in group.
Group SN	5.895 ± 1.204	5.894 ± 1.204	4.998 ± 1.190^a a p < 0.001 evaluation in group.

Sociedade Brasileira de Anestesiologia R. Professor Alfredo Gomes, 36, 22251-080 Botafogo RJ Brasil, Tel: +55 21 2537-8100, Fax: +55 21 2537-8188 - Campinas - SP - Brazil
E-mail: bjan@sbahq.org

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[1] Corresponding author. E-mail: basagan@uludag.edu.tr, esramercan76@yahoo.com (E.M. Efe).