Atracurium in the myasthenic patient

Bell, Caitlin; Florence, A. M.; Hunter, Jennifer M.; Jones, R. S.; Utting, J.E.

doi:10.1111/j.1365-2044.1984.tb08883.x

Cited by 40 publications

(17 citation statements)

References 13 publications

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“…Neuromuscular effects of non-depolarizing muscle relaxants (NDMRs) are known to be prolonged in patients with myasthenia gravis (MG) (1)(2)(3)(4). Th' is can be due to a reduction in the number of functional acetylcholine receptors in variably involved skeletal muscles (5).…”

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confidence: 99%

A comparison between vecuronium and atracurium in myasthenia gravis

Chan

Yang

Huang

et al. 1993

Acta Anaesthesiol Scand

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We evaluated the effect of vecuronium bromide and atracurium besylate on the train-of-four response in the management of muscle relaxation in 20 patients with myasthenia gravis (MG) who were undergoing thymectomy. We confirmed the safe use of these two non-depolarizing muscle relaxants in MG patients. Vecuronium (0.04 mg.kg-1) demonstrated a lesser clinical duration than did atracurium (0.2 mg.kg-1) (38 +/- 19 vs 50 +/- 21 min, mean +/- s.e.mean). The recovery time for vecuronium patients was shorter than that for atracurium patients (22 +/- 18 vs 38 +/- 18 min), but the time until onset of neuromuscular blockade was longer with vecuronium (246 +/- 105 vs 107 +/- 103 s). During spontaneous recovery from neuromuscular relaxation, at T1/C of 25% and 100%, the train-of-four fade with vecuronium was significantly greater than that with atracurium (0.04 +/- 0.02, 0.16 +/- 0.03 vs 0.17 +/- 0.01, 0.83 +/- 0.03), suggesting that vecuronium had a greater prejunctional effect than did atracurium.

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A comparison between vecuronium and atracurium in myasthenia gravis

Chan

Yang

Huang

et al. 1993

Acta Anaesthesiol Scand

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“…The present report shows that the myasthenic patient is sensitive to rocuronium, similar t o other intermediate-acting nondepolarising muscle relaxants such as atracurium [3,4] and vecuronium [5,6]. The reduction of the number of functional acetylcholine receptors at the neuromuscular junction of the myasthenic patient and the consequent reduction of the safety margin, make myasthenic patients extremely sensitive to nondepolarising muscle relaxants [7]; the speed of onset of neuromuscular block is accelerated [8], the degree of block is potentiated and the rate of recovery is decreased.…”

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confidence: 69%

Rocuronium in the myasthenic patient

Baraka

Haroun-Bizri

et al. 1995

Anaesthesia

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“…[3] Atracurium at a dose of 10%-20% of the normal dose has been suggested as the relaxant of choice. [56] Children on high dose steroids will require perioperative steroid supplementation. [7]…”

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confidence: 99%

Sevoflurane and thoracic epidural anesthesia for trans-sternal thymectomy in a child with juvenile myasthenia gravis

Rangasamy

Kumar

Rai

et al. 2014

J Anaesthesiol Clin Pharmacol

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Literature on anesthetic management of juvenile myasthenia gravis (JMG) for thymectomy is limited. Recently, use of inhalational agents and total intravenous anesthesia with propofol and remifentanyl has been reported. All these techniques individually or in combination have been tried to avoid the use of muscle relaxant. We report successful use of sevoflurane as sole anesthetic agent for intubation and in combination with thoracic epidural anesthesia for intraoperative anesthetic management in a 5-year-old child with JMG.

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Atracurium in the myasthenic patient

Abstract: S u m m a r y

Cited by 40 publications

References 13 publications

A comparison between vecuronium and atracurium in myasthenia gravis

A comparison between vecuronium and atracurium in myasthenia gravis

Rocuronium in the myasthenic patient

Sevoflurane and thoracic epidural anesthesia for trans-sternal thymectomy in a child with juvenile myasthenia gravis

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