title: [Drug onset time of atracurium after pancuronium priming in elderly patients].
abstract: Synergism occurs between some combinations of non-depolarising muscle relaxants. To test the effect of pancuronium as a priming dose of atracurium, 45 adults were anaesthetised with 25 micrograms/kg alfentanil. 75 micrograms/kg midazolam, and 0.25 mg/kg edomidate, O2/N2O and enflurane, and were randomised to one of three groups. After induction, 15 patients received 0.5 mg/kg atracurium, 15 were primed with 0.075 mg/kg atracurium and another 15 with 0.0125 mg/kg pancuronium and three minutes later 0.45 mg/kg atracurium. Neuromuscular response was monitored by adductor pollicis electromyogram (EMG) by stimulating in a TOF pattern. Times for tI reduction of 75, 50, 25 and 0% and tI recovery to 10% were taken. There were no differences between the two groups that received only atracurium. The pancuronium priming group showed a significantly faster onset of neuromuscular blockade (tI = 0%: control group I: 76.3 +/- 15.4 sec vs. pancuronium group III: 64.3 +/- 11.3 sec) and a prolonged recovery. Pancuronium priming can shorten the onset time of atracurium while atracurium priming alone showed no shortening. This suggests a synergism for pancuronium priming in combination with atracurium.
authors.affiliation: Klinik für Anästhesiologie, Universität Erlangen-Nürnberg. Goetz.Geldner@medizin.uni-ulm.de
authors.forename: G
authors.initials: G
authors.lastname: Geldner
authors.forename: U
authors.initials: U
authors.lastname: Fleischmann
authors.forename: J
authors.initials: J
authors.lastname: Weinberger
authors.forename: G G
authors.initials: GG
authors.lastname: Braun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D001143:Arousal / Q000187:drug effects*; D001279:Atracurium; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D004576:Electromyography / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents; D010197:Pancuronium; D011292:Premedication
chemical_list: D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D010197:Pancuronium
vernacular_title: Anschlagszeiten von Atracurium nach Pancuronium-Priming bei älteren Patienten.