title: Clinical experience and plasma laudanosine concentrations during the infusion of atracurium in the intensive therapy unit.
abstract: 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.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001279:Atracurium / Q000008:administration & dosage*; D002648:Child; D003422:Critical Care; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007385:Intermittent Positive-Pressure Ventilation; D007546:Isoquinolines / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D007546:Isoquinolines; D001279:Atracurium; C001522:laudanosine