Neuromuscular effects of atracurium in man. Anesth Analg 1982;61:730-4.The neurornuscular effects of atracuriurn were studied in 25 A.S.A. class I or II patients anesthetized by a N20-02 narcotic technique. In five patients incremental doses of 0.05 to 0.1 mg/kg of atracurium were given intravenously every 3 minutes until approximately 95% depression of the evoked electromyographic (EMG) response of the adductor policus muscle was produced. This required 0.25 to 0.35 rng/kg of atracurium. The duration of block (return to 95% of control) was 25 to 50 minutes. In addition, four groups of five patients each received 0.1 5, 0.25, 0.375, or 0.6 mg/ kg of atracurium. The block produced by 0.15 mg/kg was 10% to 92% and lasted 8 to 55 minutes. The block produced by 0.25, 0.375, and 0.6 mg/kg was 95% or greater with a duration of action of 30 to 68 minutes, 52 to 70 minutes, and 65 to 95 minutes, respectively. Tracheal intubation was easily carried out in all patients in whom there was a block of 90% or greater. The block could be antagonized by the common clinical combination of atropine and neostigmine. Changes in heart rate and blood pressure following atracurium were less than 5%.
Quazepam is a new benzodiazepine that may provide good hypnotic action with negligible effect on motor coordination or respiration. Sleep laboratory studies on human volunteers have shown quazepam 15 mg to be an effective hypnotic dose, with the 30-mg dose being optimal. At these doses, there was no deterioration of motor performance, and the drug, when given nightly for two weeks, continued to exert hypnotic effects without serious adverse effects. Therefore, this study was designed to compare the respiratory effects of quazepam 15 and 30 mg to those of pentobarbital 50 and 150 mg and to placebo. Five adult male volunteers received each dose at separate times. A double-blind technique was employed for controlled rebreathing studies, to a ventilation of 40 L/min or a PETCO2 of 8%. Respiratory curves were compared with controls. The mean displacement curve at the 20-liter intercept showed a depressant effect for pentobarbital 150 mg at two hours and a stimulant effect for quazepam 15 mg at two hours but a slight depression effect for quazepam 30 mg at three hours compared with placebo. The slope of the respiratory curve was not affected.
Atracurium during halothane anesthesia in humans. Anesth Analg 1983;62:207-10. The neuromuscular effects of atracurium were studied in 20 patients anesthetized with 0.8% end-tidal halothane. Neuromuscular blockade was monitored by recording the electromyogruphic activity of the adductor pollicis muscle resulting from stimulation of the ulnar nerve. Four groups offive patients received singleatracurium dosesof 0.1,0.15, 0.2, or 0.4 mglkg, respectively. The block produced by 0.1 mglkg was 25-72% and lasted 6-21 rnin. The block produced by 0.15 mglkg was 69-93% and lasted 16-32 min. The blocks produced by 0.2 and 0.4 mglkg were 95% or greater and lasted 42-84 rnin and 55-104 rnin, respectively. When indicated, intubation was easily performed in all patients receiving 0.2 and 0.4 mglkg. The block could be readily antagonized by neostigmine and atropine. Changes in heart rate and blood pressure following atracurium administration averaged less than 5 % . Key Words: NEUROMUSCULAR RELAXANTS: a tracurium.Atracurium (BW33A) is a new nondepolarizing neuromuscular blocking agent (1,2). Initial work in Great Britain showed the efficacy and safety of atracurium in humans (3), and more recent studies have demonstrated the action of atracurium in patients during narcotic anesthesia (4,5). We report here the neuromuscular effects of atracurium during halothane anesthesia in humans.
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