Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Priming principle with atracurium.

H K Nielsen1, O May, O Ravlo

  • 1Department of Anesthesia, Esbjerg Central Hospital, Denmark.

Acta Anaesthesiologica Belgica
|January 1, 1990
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Short- and long-term effects of the patient education strategy-learning and coping-in cardiac rehabilitation: a randomized controlled trial (LC-REHAB).

Health education research·2021
Same author

Basal Ti level in the human placenta and meconium and evidence of a materno-foetal transfer of food-grade TiO<sub>2</sub> nanoparticles in an ex vivo placental perfusion model.

Particle and fibre toxicology·2020
Same author

Effects of the patient education strategy 'Learning and Coping' in cardiac rehabilitation on readmissions and mortality: a randomized controlled trial (LC-REHAB).

Health education research·2020
Same author

The prognostic value of the frontal QRS-T angle is comparable to cardiovascular autonomic neuropathy regarding long-term mortality in people with diabetes. A population based study.

Diabetes research and clinical practice·2018
Same author

Outcomes of cup revision for ilio-psoas impingement after total hip arthroplasty: Retrospective study of 46 patients.

Orthopaedics & traumatology, surgery & research : OTSR·2017
Same author

Endoscopic or arthroscopic iliopsoas tenotomy for iliopsoas impingement following total hip replacement. A prospective multicenter 64-case series.

Orthopaedics & traumatology, surgery & research : OTSR·2017
Same journal

Intraoperatively diagnosed tracheal tear during a parathyroidec- tomy with previously undiagnosed tracheomalacia: a case report.

Acta anaesthesiologica Belgica·2018
Same journal

Ultrasound-guided axillary brachial plexus blocks for pseudo- syndactyly surgeries in a patient with epidermolysis bullosa: a case report.

Acta anaesthesiologica Belgica·2018
Same journal

Opioid-free anesthesia: what about patient comfort? A prospective, randomized, controlled trial.

Acta anaesthesiologica Belgica·2018
Same journal

Intraoperative administered tramadol reduces the need for piritramide in the immediate postoperative period in children undergoing adenotonsillectomy: A retrospective observational study.

Acta anaesthesiologica Belgica·2018
Same journal

Preoperative frailty assessment: a review.

Acta anaesthesiologica Belgica·2018
Same journal

Remifentanil PCIA during labor and delivery: can we improve maternal monitoring?.

Acta anaesthesiologica Belgica·2018
See all related articles

The priming principle using atracurium offers faster onset for neuromuscular blockade during gynecological surgery. Individual patient response varies, necessitating modified priming techniques for safe, rapid anesthetic induction.

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • The
  • priming principle
  • is a technique used to accelerate neuromuscular blockade onset.
  • Neuromuscular blocking agents are crucial for surgical procedures requiring muscle relaxation.
  • Atracurium is a non-depolarizing neuromuscular blocking agent commonly used in anesthesia.

Purpose of the Study:

  • To evaluate the efficacy of the priming principle for atracurium administration in patients undergoing gynecological surgery.
  • To compare the onset time of neuromuscular blockade between the priming technique and a standard bolus injection of atracurium.
  • To assess the variability in neuromuscular depression following a priming dose of atracurium.

Main Methods:

  • Randomized controlled trial involving 44 patients undergoing elective gynecological surgery.

Related Experiment Videos

  • Group I received a priming dose of atracurium (0.1 mg/kg IV) followed by a larger dose (0.5 mg/kg) after 6 minutes.
  • Group II received a standard bolus injection of atracurium (0.6 mg/kg). Neuromuscular blockade was monitored using train-of-four (TOF) ratio.

    • Main Results:

    • The priming group (Group I) demonstrated a significantly more rapid onset of neuromuscular blockade (median 61 sec) compared to the bolus group (Group II, median 83 sec).
    • In the priming group, the median TOF ratio was 0.80, with significant individual variability (30% > 0.90, 22% < 0.70) 6 minutes after the priming dose.
    • A fixed pretreatment dose per kilogram of body weight was not feasible due to wide individual variations in neuromuscular depression.

    Conclusions:

    • The priming principle with atracurium significantly accelerates neuromuscular blockade onset in gynecological surgery.
    • Significant individual variability in response to priming doses highlights the need for careful monitoring.
    • Modified priming strategies, using incremental doses guided by TOF monitoring, may offer a safe alternative for rapid induction when suxamethonium is contraindicated.