Abstract
We have assessed the profiles of plasma concentration of atracurium and its neuromuscular blocking effect on the first response of the train-of-four measured by electromyography after a short infusion of atracurium 0.25 mg kg-1, in 38 patients anaesthetized by one of three techniques. Measures of the temporal profile of neuromuscular block were found to correlate with pharmacokinetic variables. When anaesthetic technique was taken into account in a multivariate model, the time to onset of 10% deprssion of T1:T0 correlated positively with the central volume of distribution (P less than 0.05). The change in T1:T0 during the 1 min after 10% depression, and the logit of maximum depression were both correlated negatively with the central volume of distribution (P less than 0.05 and P less than 0.01, respectively). Both the times to 20% and 50% recovery of T1:T0 correlated strongly negatively with clearance (P less than 0.0001 for both measures). The findings support the conclusion that the effect of atracurium is dependent upon its disposition.
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