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What is Shortest acting competitive neuromuscular blocker? and explain in detail?
Ans. a (Mivacurium) (Ref. Anaesthesia by Ajay Yadav, 3rd ed., p 93)# MIVACURIUM is Shortest acting nondepolarising muscle relaxant is (10 min).MIVACURIUM# Among all nondepolarising muscle relaxants it has shortest duration of action,# Is an ideal M-relaxant for day care anesthesia.# Usually no reversal required.# Mivacurium is indicated as an adjunct to anesthesia to facilitate endotracheal intubation and to induce skeletal muscle relaxation in the surgical field.# Metabolised by Pseudocholinesterase enzyme (similar to succinylcholine).Properties of nondepolarizing muscle relaxantsRelaxantEd95* (Mg/ Kg)Intubating Dose (Mg/ Kg)Onset After IntubatingDuration (Minutes)Short-acting# Mivacurium0.080.21-1.515-20# Rocuronium0.30.62-330Intermediate-acting# Rocuronium0.31.21.060# Vecuronium0.050.15-0.21.560# Atracurium0.230.751-1.545-60# Cisatracurium0.050.2260-90Long-acting# Pancuronium0.070.08-0.124-590# Pipecuronium0.050.07-0.853-580-90# Doxacurium0.0250.05-0.083-590-120Educational points:DRUGS METABOLIZED BY PSEUDOCHOLINESTERASE# Propandid# Remifentanyl# Esmolol (Mnemonic: PREM SE)# Mivacuronium# Scoline# Ester linked LA (except cocaine)Rocuronium & Mivacurium can be used in Rapid sequence induction as muscle relaxants...