Influence of Propofol and Sevoflurane on the Mivacurium Chloride-induced Histamine Release_West China Medical Journal

Authors：

 JIANGYing-ying ,  LIUBin

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIUBin, Email: liubinhx@foxmail.com

Keywords：

Mivacurium chloride; Histamine; Propofol; Sevoflurane

DOI：

10.7507/1002-0179.20150252

Video：

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Objective To explore the influence of propofol as well as sevoflurane on the histamine release induced by mivacurium chloride. Methods Forty patients with American Sociaty of Anesthesiologists stage Ⅰ-Ⅱ scheduled to receive ear-nose-throat surgery between March and October 2012 were recruited and were randomly assigned into two groups:propofol group and sevoflurane group. Patients in the propofol group were induced with targeted intravenous infusion with propofol. Patients in the sevoflurane group was induced with sevoflurane. The blood specimen was prepared before mivacurium chloride (0.16 mg/kg) infusion (T₀), 1 minute (T₁), 3 minutes (T₂), and 5 minutes (T₃) after the infusion. Mean blood pressure (MBP) and heart rate (HR) were recorded at corresponding time points. In addition, we recorded the symptoms of anaphylactic reaction such as skin erythema or bronchospasm. Results Both MBP and HR decreased after anesthesia induction. However, there was no significant difference from that before the induction in both groups, and no difference was found between the two groups (P>0.05). The concentration of histamine in both groups at T₁ and T₂ was significantly higher than that at T₀ (P<0.05). The concentration of histamine in both groups at T4 was significantly higher than that at T₀ (P<0.05). The concentration of histamine in the propofol group was higher than that in the sevoflurane group. No skin erythema or bronchospasm was found in any of the two groups. Conclusion Mivacurium chloride at a dose of 0.16 mg/kg can be safely used in propofol anesthesia, as well as sevofluane anesthesia, with no clinically significant histamine release or adverse hemodynamic fluctuation.

Citation： JIANGYing-ying, LIUBin. Influence of Propofol and Sevoflurane on the Mivacurium Chloride-induced Histamine Release. West China Medical Journal, 2015, 30(5): 877-880. doi: 10.7507/1002-0179.20150252 Copy

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3.	Dieck T, Steffens J, Sander B, et al. Propofol, remifentanil and mivacurium:fast track surgery with poor intubating conditions[J]. Minerva Anestesiol, 2011, 77(6):585-591.
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7.	孙大金. 麻醉期间的药物过敏反应[J]. 国际麻醉学与复苏杂志, 2007, 28(5):477-480.
8.	赵琳, 韩如泉, 崔伟华. 抗组胺药预防米库氯铵引起组胺释放反应的临床研究[J]. 世界中西医结合杂志, 2013, 8(12):1239-1242.
9.	Grim KJ, Abcejo AJ, Barnes A, et al. Caveolae and propofol effects on airway smooth muscle[J]. Br J Anaesth, 2012, 109(3):444-453.
10.	Tas P, Stoessel C, Roewer N. Inhibition of the histamine-induced Ca²⁺ influx in primary human endothelial cells (HUVEC) by volatile anaesthetics[J]. Eur J Anaesthesiol, 2008, 25(12):976-985.
11.	李曼玲. 异丙酚引起过敏反应一例报告[J]. 临床麻醉学杂志, 2000, 16(2):80.
12.	Nishiyama T. Propofol results in higher incidence of bronchoconstriction in allergic patients[J]. Med Arch, 2013, 67(3):168-170.
13.	Murphy A, Campbell DE, Baines D, et al. Allergic reactions to propofol in egg-allergic children[J]. Anesth Analg, 2011, 113(1):140-144.
14.	叶沈平, 刁玉刚, 赫凌峰, 等. 异丙酚引起支气管痉挛2例[J]. 实用医学杂志, 2007, 23(10):1513.
15.	Xiang Z, Yan-Liang Q, Xiao-Yang S, et al. Effects of promethazine or dexamethasone pretreatment on mivacurium-induced histamine release in children[J]. Paediatr Anesth, 2014, 24(3):322-326.
16.	Osman ES, Khafagy HF, Radwan KG, et al. Role of cholinesterase activity on pharmacodynamics of mivacurium preceded by pancuronium in elderly and young adults[J]. J Egypt Soc Parasitol, 2007, 37(1):243-255.

1. 吕慧, 马鹤, 朱卓, 等. 新型非去极化肌松药-米库氯铵[J]. 中国实验诊断学, 2013, 17(7):1359-1361.
2. Molbegott L, Baker T. Speed and ease of tracheal intubation:priming with mivacurium compared with succinylcholine[J]. Can J Anaesth, 1995, 42(9):780-784.
3. Dieck T, Steffens J, Sander B, et al. Propofol, remifentanil and mivacurium:fast track surgery with poor intubating conditions[J]. Minerva Anestesiol, 2011, 77(6):585-591.
4. Dong SW, Mertes PM, Petitpain N, et al. Hypersensitivity reactions during anesthesia. Results from the ninth French survey (2005-2007)[J]. Minerva Anestesiol, 2012, 78(8):868-878.
5. Sadleir P, Clarke RC, Bunning DL, et al. Anaphylaxis to neuromuscular blocking drugs:incidence and cross-reactivity in Western Australia from 2002 to 2011[J]. Br J Anaesth, 2013, 110(6):981-987.
6. Saager L, Turan A, Egan C, et al. Incidence of intraoperative hypersensitivity reactions:a registry analysis[J/OL]. Anesthesiology, 2014(26). http://www.ncbi.nlm.nih.gov/pubmed/?term=Saager+L%2C+Turan+A%2C+Egan+C%2C+et+al.+Incidence+of+intraoperative+hypersensitivity+reactions%3Aa+registry+analysis%5BZ%5D%2C+2014.
7. 孙大金. 麻醉期间的药物过敏反应[J]. 国际麻醉学与复苏杂志, 2007, 28(5):477-480.
8. 赵琳, 韩如泉, 崔伟华. 抗组胺药预防米库氯铵引起组胺释放反应的临床研究[J]. 世界中西医结合杂志, 2013, 8(12):1239-1242.
9. Grim KJ, Abcejo AJ, Barnes A, et al. Caveolae and propofol effects on airway smooth muscle[J]. Br J Anaesth, 2012, 109(3):444-453.
10. Tas P, Stoessel C, Roewer N. Inhibition of the histamine-induced Ca²⁺ influx in primary human endothelial cells (HUVEC) by volatile anaesthetics[J]. Eur J Anaesthesiol, 2008, 25(12):976-985.
11. 李曼玲. 异丙酚引起过敏反应一例报告[J]. 临床麻醉学杂志, 2000, 16(2):80.
12. Nishiyama T. Propofol results in higher incidence of bronchoconstriction in allergic patients[J]. Med Arch, 2013, 67(3):168-170.
13. Murphy A, Campbell DE, Baines D, et al. Allergic reactions to propofol in egg-allergic children[J]. Anesth Analg, 2011, 113(1):140-144.
14. 叶沈平, 刁玉刚, 赫凌峰, 等. 异丙酚引起支气管痉挛2例[J]. 实用医学杂志, 2007, 23(10):1513.
15. Xiang Z, Yan-Liang Q, Xiao-Yang S, et al. Effects of promethazine or dexamethasone pretreatment on mivacurium-induced histamine release in children[J]. Paediatr Anesth, 2014, 24(3):322-326.
16. Osman ES, Khafagy HF, Radwan KG, et al. Role of cholinesterase activity on pharmacodynamics of mivacurium preceded by pancuronium in elderly and young adults[J]. J Egypt Soc Parasitol, 2007, 37(1):243-255.

West China Medical Journal

Influence of Propofol and Sevoflurane on the Mivacurium Chloride-induced Histamine Release

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