Clinical comparison of atracurium and alcuronium in gynaecological surgery

In a double-blind, prospective, randomised trial in 51 female patients, atracurium 0.6mg/kg provided acceptable intubating conditions more rapidly than did alcuronium 0.25 mg/kg. Atracurium produced more profound neuromuscular twitch suppression than alcuronium. The effect of atracurium was longer-lasting than that of alcuronium (32 minutes and 22 minutes respectively to achieve 10% recovery) and it took slightly longer to reverse with neostigmine. Seven patients in the atracurium group who underwent short surgical procedures required supplementary neostigmine to achieve adequate reversal. Two cases of sinus bradycardia were noted in the atracurium group, but hypotension was not a clinical problem in any patient. Atracurium appears to be a useful relaxant, but a smaller dose than that used here should be chosen for short procedures.