Détermination de la courbe dose-effet du dibésylate d'atracurium chez l'homme adulte anesthésié

Abstract

The mechanical response of the adductor pollicis to a 0.15 Hz stimulation of the ulnar nerve was studied in 35 unpremedicated adult patients (mean age 38 yr) under general anaesthesia using thiopentone, fentanyl and a N 2O/O 2 mixture under mechanical ventilation. PaCO 2, pH, K, Ca, Mg plasma levels and temperature were in the normal range. Each patient received a single bolus of atracurium dibesylate : 0.10 mg · kg −1 (n = 11), 0.15 mg · kg −1 (n = 10), 0.20 mg · kg −1 (n = 11) or 0.30 mg · kg −1 (n = 4). The dose-response curve was constructed using the log-probit method for 0.10, 0.15, 0.20 mg · kg −1 doses, giving neuromuscular blocks greater than 0 % and less than 100 %. The ED 50 and ED 95 were respectively 0.13 and 0.20 mg · kg −1. The 0.20 mg · kg −1 dose had an onset time of 6.1±0.6 min, duration 0–90 % of 34.3±3.2 min and a recovery index 25–75 % of 10.9±1.0 min. The 0.3 mg · kg −1 dose resulted in onset time of 4.7±1.3 min, duration of 39.9±3.7 min and a recovery index of 10.7±1.8 min. Thus atracurium dibesylate seemed to be an agent of intermediate potency. Onset time was approximately the same as that for other non-depolarizing neuromuscular blocking drugs, but duration of action and recovery index were quite shorter, except for vecuronium bromide.