Histamine release following atracurium in the elderly

Histamine release and neuromuscular blocking drugs

“…Thus a change in the plasma level is of particular import. The short-lived histamine peak demonstrated to occur at 2 min after administration of atracurium in this issue [7] is of a similar time course to the evanescent cardiovascular changes, and local skin responses, well recognised by the clinician after the administration of this muscle relaxant.…”

“…In this issue, Shorten and colleagues [7] have questioned the relationship between a change in plasma histamine concentration, presumably liberated by the direct action of the drug, and the decrease in blood pressure found in a small group of elderly patients given atracurium 0.6 mg.kg-'. They detected no significant correlation between these two parameters, and as a similar decrease in mean arterial blood pressure occurred in a well-matched group of patients given vecuronium 0.1 mg.kg-', the authors doubted whether the effect was due to histamine release.…”