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Prolonged infusion of atracurium in an infant
Y Tabardel1, T Paquay, J Senterre
1Department of Pediatrics, University of Liège, Belgium.
Insights
This study found that a 6-month-old infant required a higher infusion rate of atracurium over 7 days. Laudanosine levels remained safe, with no observed side effects or drug accumulation.
Area of Science:
- Anesthesiology
- Clinical Pharmacology
- Pediatric Critical Care
Background:
- Atracurium is a neuromuscular blocking agent that undergoes spontaneous degradation via Hoffmann reaction.
- Understanding its pharmacokinetics during prolonged infusions in infants is crucial for safe and effective use.
Abstract:
Atracurium is a neuromuscular blocking agent that spontaneously degrades by Hoffmann reaction. This study of a prolonged infusion (7 days) in an infant of 6 months shows an increase in infusion rate requirement from 0.7 mg/kg/h after 96 h of infusion to 1.8 mg/kg/h at the 7th day. The plasma laudanosine levels remained relatively constant (977-1,515 ng/ml) and well below the reported potent convulsive levels during the study despite a 3-fold increase in the atracurium requirement. No side effect or accumulation of the drug was observed. The reasons for the increase in atracurium requirement are discussed.