Atracurium Administered by Infusion for Long Neurosurgical Procedures

Abstract

In a clinical trial of atracurium given by continuous infusion at 0.5 mg kg−1 h−1 during craniotomy in 15 patients anaesthetized with thiopentone, pentobarbitone, fentanyl and nitrous oxide in oxygen, neuromuscular blockade was evaluated using train-of-four (TOF) and twitch height (TH). A bolus of atracurium was given initially and an infusion of atracurium 0.5 mg kg−1 h−1 was started when TH 0.05 reappeared. The median duration of infusion was 190 min (range 42–285 min) and the median total dose was 2.2 mg kg-1 (range 0.9–3.1 mg kg−1). Spontaneous recovery from neuromuscular blockade (TOF = 0.70) occurred 44 min (range 30–95 min) following termination of infusion. The recovery time from neuromuscular blockade was independent of duration of infusion within 5 h.