Residual curarisation: a comparative study of atracurium and pancuronium

Sixty patients (17-78 years old, ASA group I-II) were included in the study, which was triple-blind, randomised, stratified and controlled. Patients were selected in pairs according to sex and type of operation, and randomly allocated to one of two groups, atracurium or pancuronium. Anaesthesia was achieved with thiopentone, pethidine and nitrous oxide in oxygen, and patients were then given atracurium 0.1 mg kg-1 or pancuronium 0.6 mg kg-1. Incremental doses were administered when clinically indicated. On recovery, residual curarisation was evaluated clinically and with the train-of-four method by a doctor who was unaware of the neuromuscular blocking agents used. Residual curarisation was found to be less after neuromuscular blockade with atracurium in the doses used in this study. Atracurium has advantages in this respect when neuromuscular monitoring is not used during operation.