Clinical experience and plasma laudanosine concentrations during the infusion of atracurium in the intensive therapy unit.
نویسندگان
چکیده
Twenty patients in the intensive care unit received an infusion of atracurium to permit mechanical ventilation. The duration of infusion ranged from 38 to 219 h and the average rate of infusion during the study was 0.76 mg kg-1 h-1. In 14 patients an increase in atracurium requirement occurred within the first 72 h of the infusion. Recovery from neuromuscular blockade after a prolonged infusion was sufficiently rapid to avoid pharmacologically induced reversal. In six patients maximum plasma concentrations of laudanosine were 1.9-5 micrograms ml-1, and there was no evidence of cerebral excitation.
منابع مشابه
Comparison of the pharmacodynamics and pharmacokinetics of an infusion of cis-atracurium (51W89) or atracurium in critically ill patients undergoing mechanical ventilation in an intensive therapy unit.
We have studied 12 critically ill, sedated patients who required a neuromuscular blocking drug to assist mechanical ventilation in an intensive care unit. Patients were randomized to receive an infusion of cis-atracurium 0.18 mg kg-1 h-1 (group 1, n = 6) or atracurium 0.6 mg kg-1 h-1 (group 2, n = 6) preceded, if necessary, by a bolus dose of 2 x ED95 of the same drug (cis-atracurium 0.1 mg kg-...
متن کاملElectroencephalographic effects of laudanosine in an animal model of epilepsy.
We examined the effects of laudanosine, one of the principal metabolites of atracurium, on the electroencephalogram (EEG) in an animal model of induced epilepsy. Fourteen rabbits were anaesthetized with 4% halothane in oxygen, the trachea intubated and the lungs ventilated mechanically with 30% oxygen and 1% halothane in nitrogen. Animals were assigned randomly to receive either an infusion of ...
متن کاملIn vitro degradation of atracurium in human plasma.
The degradation of atracurium and the formation of laudanosine was examined in vitro in both Sorensen buffer and human plasma using sensitive, specific high pressure liquid chromatographic assays to determine drug concentrations. At normal physiological pH and temperature, the degradation of atracurium was threefold more rapid in plasma than in buffer. Laudanosine is the major end-product of at...
متن کاملBlockade and activation of the human neuronal nicotinic acetylcholine receptors by atracurium and laudanosine.
BACKGROUND Curaremimetic nondepolarizing muscle relaxants are widely used in clinical practice to prevent muscle contraction either during surgery or during intensive care. Although primarily acting at the neuromuscular junction, these compounds can cause adverse effects, including modification of cardiac rhythm, arterial blood pressure, and in the worst cases, triggering of seizures. In this s...
متن کاملTransplacental distribution of atracurium, laudanosine and monoquaternary alcohol during elective caesarean section.
Maternal venous (MV), umbilical venous (UV) and umbilical arterial (UA) blood samples were obtained for assay of atracurium, laudanosine and monoquaternary alcohol concentrations in 22 healthy patients undergoing elective Caesarean section under general anaesthesia. At delivery (at a mean time of 8.2 min after atracurium 0.3 mg kg-1), the mean UV concentrations were 103 ng ml-1 (range 44-189 ng...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 59 2 شماره
صفحات -
تاریخ انتشار 1987