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Potency and maintenance requirement of atracurium and vecuronium given alone or together
Author(s) -
Rautoma P.,
Erkola O.,
Meretoja O. A.
Publication year - 1995
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1995.tb04047.x
Subject(s) - medicine , potency , vecuronium bromide , atracurium besilate , anesthesia , neuromuscular blockade , pharmacology , biochemistry , chemistry , in vitro
A synergism exists between some competitive muscle relaxants. However, maintenance requirement of a combination of muscle relaxants has been evaluated only in paediatric patients. We studied 45 elective adult surgical patients (ASA I‐II) during propofol‐alfentanyl‐N 2 O‐O 2 ‐anaesthesia. The first 30 patients were randomized to receive either atracurium or vecuronium to create individual dose‐response curves for these muscle relaxants. ED 95 ‐values for atracurium and vecuronium were 260±9 and 59±3 μg · kg ‐1 , respectively (mean±s.e.mean). Requirements of atracurium and vecuronium to maintain an 85–95% neuromuscular blockade were 301 and 83 μg kg ‐1 h ‐1 , respectively. An additional 15 patients received a combination of atracurium and vecuronium (cAV) in an equipotent dose ratio. An ED 95 of a cAV was 94± 7 μg · kg ‐1 of atracurium together with 21±2 μg · kg ‐1 of vecuronium, or 72±6% of one ED 95 dose of a parent agent. Potentiation was significant ( P =0.0001). A maintenance requirement of a cAV was 120 μg kg ‐1 h ‐1 of atracurium together with 27 μg kg ‐1 h ‐1 of vecuronium. Thus, a significant potentiation was maintained also during the course of anaesthesia. A cAV had an effect like one intermediate‐acting agent. If a cAV is used instead of using atracurium or vecuronium alone, the maximal reduction of drug consumption would be approximately 30%.