Comparison of neuromuscular block of atracurium and rocuronium in adults.
We studied the time-course of action of atracurium 0.5 mg kg-1 and rocuronium 0.6 mg kg-1 in 24 healthy adult patients. Anesthesia was induced with thiopentone and sufentanil, and maintained with 50% nitrous oxide and 1% enflurane in oxygen. Neuromuscular transmission was monitored by stimulating the ulnar nerve at the wrist and measuring the acceleration of the thumb using the TOF-Guard accelerograph monitor. Supramaximal stimuli of 0.2 ms duration were applied in a single twitch stimulation mode at 1 Hz frequency until completion of block, and in train-of four (TOF) sequence at 2 Hz every 15 sec thereafter. Onset time was longer with atracurium (mean +/- SD:90 +/- 18 sec) than with rocuronium (49 +/- 6 sec). Clinical duration of action (Tl25) was longer with atracurium (52.3 +/- 7.2 min) than with rocuronium (40.0 +/- 6.4 min). Recovery index (Tl25-Tl75) and time for TOF ratio to recover to 0.75 were 17.8 +/- 4.2 and 73.9 +/- 8.8 min with atracurium, and 13.8 +/- 4.1 and 70.4 +/- 14.1 min with rocuronium. The differences between both groups were statistically significant except the difference in the time for TOF to return to 0.75.
Hans
P
P
University Department of Anaesthesia, CHR de la Citadelle, CHU Liège, Belgium.
Brichant
J F
JF
Franzen
A
A
Faleres
X
X
Lamy
M
M
D000328:Adult; D000732:Androstanols / Q000494:pharmacology*; D001279:Atracurium / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D000077123:Rocuronium; D009435:Synaptic Transmission / Q000187:drug effects*; D013997:Time Factors; D014459:Ulnar Nerve / Q000502:physiology
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D000077123:Rocuronium