Histamine release following atracurium in the elderly

A study was performed to evaluate histamine release, as well as potential cardiovascular and cutaneous sequelae, following bolus administration of atracurium in elderly patients. In 15 patients, using a radioenzymatic technique, plasma histamine concentrations were measured in venous blood samples obtained before and after induction of anaesthesia with thiopentone and at 2 and 5 min after administration of atracurium (0.6 mg.kg-1) over 30 s. Blood pressure and pulse rate were measured noninvasively and cutaneous changes sought and compared with those seen in 12 similar patients who received vecuronium (0.1 mg.kg-1). Our findings indicate that the histamine releasing property of atracurium in elderly patients is greater than that in children, similar to that in adolescents and less than that in nonelderly adults. The decreases in blood pressure following atracurium and vecuronium in elderly patients are similar.