title: Atracurium during induced hyperthermia.
abstract: During hyperthermic intraperitoneal chemotherapy (HIPEC), we observed a partial recovery from neuromuscular block in a hyperthermic patient after hours of monitored adequate surgical relaxation and continuous infusion of atracurium during normothermia. This recovery is indicative of the higher clearance of atracurium during hyperthermia. This case report emphasizes the clinical relevance of the well-known temperature dependence of the Hofmann elimination of atracurium. Moreover, this report illustrates the importance of monitoring muscle relaxation during HIPEC. Clinicians should be aware that the usual continuous infusion rate of atracurium at 0.3 mg.kg(-1).h(-1) may be inadequate in hyperthermic patients.
authors.affiliation: Department of Pediatric Anesthesiology, Wilhelmina Children's Hospital, University Medical Centre, P.O. Box 85090, Utrecht 3508 AB, The Netherlands.
authors.forename: Gersten
authors.initials: G
authors.lastname: Jonker
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Hoogenboom
authors.forename: Bert
authors.initials: B
authors.lastname: van Ramshorst
authors.forename: Peter
authors.initials: P
authors.lastname: Bruins
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000767:Anesthesia, Epidural; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001279:Atracurium / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium
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