Correlación entre la concentración molar del atracurio y su tiempo de comienzo o velocidad de acción

Abstract

To study the correlation between the subparalyzing dose of atracurium and its onset time and speed of action. Six groups of patients received 0.36, 0.68, 0.98, 1.44, 1.77, or 2.06 times the median effective dose of atracurium. The maximal effect, onset time, molar potency (microM kg(-1)) and speed of action (relationship between time in seconds and percentage of maximum effect and between percentage of maximum effect and time) of each dose were measured. The values were converted to logarithms and square roots to test for correlations. The regression line provided the equation, coefficient of determination (R2), and statistical significance. The correlation between the logarithms of molar potency and onset time was poor and not statistically significant (R2 = 0.564, P = .138), whereas the correlations between the logarithms of molar potency and speed of action (seg/%) (s/maximum % effect, R2 = 0.952; and maximum % effect/s, R2 = 0.984) were strong and statistically significant (P < .0001) The regression formulas were able to predict the onset time. The results were similar when the values were converted to their square roots. The onset time of a neuromuscular blocker is linked to its effect and its permeability is linked to the size of its molecules or the molar potency, which is dose-dependent. In the case of atracurium, this correlation was poor and not significant. This finding coincides with those of other authors, who found that atracurium was distant from the regression line for equipotent quantities of different neuromuscular blockers. Substituting onset time with speed of action, however, made it possible to establish a strong and significant correlation. Our results suggest that the speed of action of atracurium depends on the size of its molecule.