Atracurium is a new non-depolarising neuromuscular blocking agent, metabolized through Hofmann elimination. A case is presented in which a 45-year-old patient with severe liver disease showed a decreased response to atracurium. The possible causes of resistance to atracurium are discussed. We conclude that atracurium may be used in patients with severe hepatic disease.

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-...

BACKGROUND AND OBJECTIVES Since atracurium can cause hypotension in humans, the hemodynamic effects of atracurium and cisatracurium as well as the hemodynamic protection of diphenhydramine and cimetidine were investigated in rats. METHODS 1) Wistar rats were anesthetized with sodium pentobarbital and prepared according to Brown et al. to evaluate different doses of atracurium and cisatracuriu...

Thirty patients with ischaemic heart disease scheduled for coronary artery bypass grafting were randomly allocated to three equal groups. Following morphine, hyoscine and pentobarbitone premedication, anaesthesia was induced with diazepam 0.3 mg kg-1. Five minutes later neuromuscular blockade was induced with pancuronium 0.1 mg kg-1, vecuronium 0.1 mg-1 or atracurium 0.5 mg kg-1, followed after...

BACKGROUND Systemic inflammation may be associated with resistance to nondepolarizing neuromuscular blocking drugs, the mechanisms of which are, however, uncharacterized. The authors therefore investigated the pharmacodynamics of atracurium and its relation to the expression of nicotinic acetylcholine receptors and alpha1 -acid glycoprotein in a rat model of systemic inflammation. METHODS To ...

Background and aim Equipotent dose of atracurium cis-atracurium has failed to show clinically equi-effective muscle relaxation actions required for laryngoscopy endotracheal intubation (LETI) in adults. There needs be more data on children. We aimed compare the efficacy equipotent producing optimal LETI. also compared hemodynamic stability side effects. Methods With approvals informed consent, ...

BACKGROUND AND OBJECTIVES Additional neuromuscular blocker doses are in general needed during wall closing after abdominal surgeries. This study aimed at determining during partial pancuronium-induced neuromuscular block recovery, the effect of additional atracurium dose on spontaneous neuromuscular block recovery. METHODS Participated in this study 30 patients divided in two groups: pancuron...

The pharmacokinetic models proposed for atracurium or cisatracurium are based on the assumption that spontaneous degradation via Hofmann elimination proceeds in vivo at the same rate as measured in vitro at pH 7.4 and 37 degrees C. As different degradation rates have been reported for all 10 stereoisomers of atracurium measured together, for each of its three isomeric groups, and for the single...

OBJECTIVE To evaluate the effect of priming atracurium over onset time and intubating time of general anesthesia between different genders. METHODOLOGY Sixty-six male and sixty-four female patients, ASA I-II, aged 18-65 years, were randomly divided into four groups: group M1: male patients with saline priming; group M2: male patients with priming atracurium dose of 0.05 mg/kg; group F1: femal...