Cerebrospinal fluid concentrations of laudanosine after administration of atracurium

The concentration of laudanosine in cerebrospinal fluid (CSF) was measured in four patients undergoing brain electrode placement after the administration of atracurium. CSF: plasma laudanosine concentration ratios ranged from less than 1 to 14%, with a range of CSF laudanosine concentrations of less than 2-14 ng ml-1. One patient had no detectable laudanosine in CSF, but sampling in this patient was possible for only 30 min. There was no atracurium detectable in the CSF of any patient. We conclude that laudanosine crosses the blood-brain barrier and further study of its central nervous system effects in man is warranted.