Atracurium infusion in total intravenous anesthesia

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Benzodiazepines may interact with non-depolarizing neuromuscular blockers.
• Understanding these interactions is crucial for safe anesthetic practice.

Purpose of the Study:

• To compare the neuromuscular blocking effect of atracurium under two different anesthetic techniques.
• To evaluate the onset and recovery of neuromuscular blockade with atracurium.

Main Methods:

• Atracurium was administered as a bolus dose (0.5 mg/kg) followed by a maintenance infusion.
• Neuromuscular blockade was assessed during conventional fentanyl/nitrous oxide anesthesia and total intravenous anesthesia (midazolam/alfentanil).
• Twitch depression and recovery times were measured.

Main Results:

• Both anesthetic techniques achieved over 90% twitch depression with atracurium.
• Onset of neuromuscular blockade was rapid in both groups (123-137 seconds).
• Recovery to 10% twitch height averaged around 32 minutes.

Conclusions:

• Atracurium's neuromuscular blocking effect is consistent regardless of whether fentanyl/nitrous oxide or midazolam/alfentanil anesthesia is used.
• The maintenance infusion dosage range (0.29-0.44 mg/kg/h) for atracurium was confirmed.
• No significant difference in atracurium's efficacy was observed between the two anesthetic regimens.