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Atracurium
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Ronald D. Miller – One of the best experts on this subject based on the ideXlab platform.
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The neuromuscular effects of sevoflurane and isoflurane alone and in combination with vecuronium or Atracurium in the rat
Journal of Anesthesia, 1992Co-Authors: Yang-sik Shin, Ronald D. Miller, James E. Caldwell, Edmond I. EgerAbstract:Sevoflurane was compared to isoflurane anesthesia alone and in combination with Atracurium or vecuronium in 84 rats using the sciatic nerve — anterior tibialis muscle preparation. Both bolus injection and infusion rate techniques were used to evaluate these drug interactions. The ED_50 (dose which produced a 50% depression of twitch tension) of Atracurium was 311±31 and 360±32 μg·kg^−1 during 1.25 MAC sevoflurane and isoflurane anesthesia respectively. The ED_50 of vecuronium was 190±27 and 149±14 μg·kg^−1 during 1.25 MAC sevoflurane and isoflurane anesthesia respectively. The mean infusion rates of Atracurium and vecuronium required to maintain a 50% depression of twitch tension were 5.04±0.7 and 2.02±0.3 mg·kg^−1·hr^−1. These infusion rates were 5.04±0.7 and 2.02±0.3 mg·kg^−1·hr^−1 during 1.25 MAC sevoflurane and 3.73±0.3 and 1.81±0.4 mg·kg^−1·hr^−1 during 1.25 MAC isoflurane anesthesia respectively. With both Atracurium and vecuronium, the infusion rate required to maintain a 50% depression twitch of tension was inversely related to the concentrations of isoflurane and sevoflurane. The authors conclude that sevoflurane is similar in potency to that of isoflurane in augmenting a vecuronium or Atracurium induced neuromuscular blockade in a dose-dependent manner.
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The neuromuscular effects of sevoflurane and isoflurane alone and in combination with vecuronium or Atracurium in the rat
Journal of Anesthesia, 1992Co-Authors: Yang-sik Shin, Ronald D. Miller, James E. Caldwell, Edmond I. EgerAbstract:Sevoflurane was compared to isoflurane anesthesia alone and in combination with Atracurium or vecuronium in 84 rats using the sciatic nerve — anterior tibialis muscle preparation. Both bolus injection and infusion rate techniques were used to evaluate these drug interactions. The ED_50 (dose which produced a 50% depression of twitch tension) of Atracurium was 311±31 and 360±32 μg·kg^−1 during 1.25 MAC sevoflurane and isoflurane anesthesia respectively. The ED_50 of vecuronium was 190±27 and 149±14 μg·kg^−1 during 1.25 MAC sevoflurane and isoflurane anesthesia respectively. The mean infusion rates of Atracurium and vecuronium required to maintain a 50% depression of twitch tension were 5.04±0.7 and 2.02±0.3 mg·kg^−1·hr^−1. These infusion rates were 5.04±0.7 and 2.02±0.3 mg·kg^−1·hr^−1 during 1.25 MAC sevoflurane and 3.73±0.3 and 1.81±0.4 mg·kg^−1·hr^−1 during 1.25 MAC isoflurane anesthesia respectively. With both Atracurium and vecuronium, the infusion rate required to maintain a 50% depression twitch of tension was inversely related to the concentrations of isoflurane and sevoflurane. The authors conclude that sevoflurane is similar in potency to that of isoflurane in augmenting a vecuronium or Atracurium induced neuromuscular blockade in a dose-dependent manner.
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Pharmacokinetics and Pharmacodynamics of Atracurium in Infants and Children
Anesthesiology, 1990Co-Authors: Dennis M. Fisher, P. Claver Canfell, Michael J. Spellman, Ronald D. MillerAbstract:To determine whether maturational changes in body composition and organ function affect distribution and elimination of and sensitivity to Atracurium, the authors determined the pharmacokinetics and pharmacodynamics of Atracurium in six infants and five children and compared these results with those obtained in five adults. Atracurium, 15.8 +/- 1.7 micrograms.kg-1.min-1, was infused iv for 6-11 min to subjects anesthetized with nitrous oxide (60%) and halothane (0.9 MAC, age-adjusted) and twitch tension of the adductor pollicis muscle was measured. Plasma samples were obtained for 120 min; concentrations of Atracurium were determined using a liquid chromatographic assay. A two-compartment pharmacokinetic model, adapted to account for elimination of Atracurium from both central and peripheral compartments, was fit to the plasma concentration data; an effect-compartment model was fit to the twitch tension data. Volume of distribution at steady state (210 +/- 118, 129 +/- 44, and 100 +/- 22 ml/kg for infants, children, and adults, respectively) and total clearance (7.9 +/- 2.0, 6.8 +/- 1.6, and 5.3 +/- 0.9 ml.kg-1.min-1 for the three groups) decreased with increasing age. Neither elimination half-life (20.0 +/- 5.1, 17.2 +/- 5.1, and 15.7 +/- 2.5 min for the three groups) nor the steady state plasma concentration that resulted in 50% neuromuscular blockade (363 +/- 118, 444 +/- 121, and 436 +/- 122 ng/ml for the three groups) varied with age. The authors conclude that these results are consistent with and explain the previously reported findings that recovery from the neuromuscular effects of Atracurium is minimally affected by age.(ABSTRACT TRUNCATED AT 250 WORDS)
A T Marr – One of the best experts on this subject based on the ideXlab platform.
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rocuronium onset of action a comparison with Atracurium and vecuronium
Anesthesia & Analgesia, 1993Co-Authors: Richard R Bartkowski, Thomas A Witkowski, Said S Azad, Jennifer Lessin, A T MarrAbstract:The onset, maximal neuromuscular block, and duration of rocuronium were compared with Atracurium and vecuronium during enflurane anesthesia. Sixty patients received rocuronium (80, 100, 120, or 160 micrograms/kg). Enflurane enhanced a rocuronium neuromuscular block in a dose-related manner; the ED50 was 104 +/- 11 and 83 +/- 7 micrograms/kg (SEM) during 1% and 2% enflurane anesthesia, respectively. Patients receiving Atracurium (0.12 mg/kg) or vecuronium (0.02 mg/kg) were studied during 1% enflurane anesthesia until seven in each group qualified by achieving a maximal block between 85% and 97%. These patients were matched with each other and with patients who had received rocuronium. Seven groups of three patients (rocuronium, vecuronium, and Atracurium) were obtained. The average difference in maximal block was less than 2% between matched patients. The ratio of dose used to achieve a similar final block suggests potency ratios of 1, 8.5, and 1.2 for rocuronium, vecuronium, and Atracurium. Rocuronium’s onset time (time from drug administration to 50%, 75%, and 90% of final block) was significantly faster than either of the other two muscle relaxants (P < 0.01). Time to 90% of final block was 1.35 min for rocuronium, 3.06 min for Atracurium, and 3.71 min for vecuronium. Using these equipotent doses, Atracurium also had a shorter time to develop neuromuscular block than vecuronium (P < 0.05). For these three intermediate duration neuromuscular blockers, speed of onset was inversely related to their potency, confirming a relationship that had been demonstrated for the long-acting drugs pancuronium, d-tubocuranine, and gallamine.
Edward L Spitznagel – One of the best experts on this subject based on the ideXlab platform.
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resistance to Atracurium induced neuromuscular blockade in patients with intractable seizure disorders treated with anticonvulsants
Anesthesia & Analgesia, 1990Co-Authors: Ren Tempelhoff, Paul A Modica, Walter S Jellish, Edward L SpitznagelAbstract:Previous studies have demonstrated that, with the exception of Atracurium, resistance to the neuromuscular blocking effects of various muscle relaxants develops in patients receiving anticonvulsant therapy. We studied the effects of 0.5 mg/kg IV Atracurium in 53 neurosurgical patients: 21 nonepilept