A study of different doses of atracurium to prevent suxamethonium-induced fasciculations

Pretreatment with 3 different doses of atracurium (0.035 mg/kg, 0.05 mg/kg, 0.07 mg/kg) was investigated in order to determine the optimal dose that would prevent suxamethonium-induced fasciculations with minimal side effects to the patient and without significant antagonism of suxamethonium block. A total of 80 patients was studied. There were 20 patients in each of three atracurium groups while a fourth group of 20 patients served as control. Atracurium reduced the incidence of fasciculations from 100% observed in the control to between 0 and 40% in the atracurium groups. The optimal dose of atracurium appears to be 0.05 mg/kg, using a pretreatment interval of 3 minutes. Routine pretreatment of all patients is not mandatory, but it is recommended whenever the side-effects of suxamethonium are particularly undesirable, as in ocular laceration, raised intracranial pressure, full stomach and in very muscular patients.