[Curarization of the myasthenia patient by atracurium].
The use of atracurium, a new intermediate duration of action non depolarizing muscle relaxant, is described in a myasthenic patient undergoing abdominal surgery. The effective dose to 95% twitch suppression is 0.15 mg.kg-1. Following the first dose, the time from maximum twitch depression to 25% recovery is 32 min, and 33 min following the second dose. The recovery index (25-75% recovery time) and the 5-90% recovery time are respectively 33 and 83 min. The train-of-four ratio is greater than 0.7 within 90 min after the reinjection. The significance of the behaviour of atracurium is discussed. In reduced dosage and with careful neuromuscular monitoring, atracurium appears to be a reasonable and safe choice of myasthenic patients to provide surgical relaxation.
Département d'Anesthésie-Réanimation Chirurgicale, Hôtel-Dieu, CHR Nantes, France.
J Y
JY
Lepage
C
C
Juge
A
A
Cozian
M
M
Malinge
R
R
Souron
D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D001279:Atracurium / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008991:Monitoring, Physiologic; D009129:Muscle Tonus / Q000187:drug effects; D009157:Myasthenia Gravis; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage; D011950:Receptors, Cholinergic / Q000502:physiology
D009466:Neuromuscular Blocking Agents; D011950:Receptors, Cholinergic; D001279:Atracurium
Curarisation du patient myasthénique par l'atracurium. Atracurium in the myasthenic patient.