Document Detail


Atracurium-induced neuromuscular block in the isolated arm.
MedLine Citation:
PMID:  1332358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A modification of the isolated arm technique was applied in 10 females under opioid-based i.v. anaesthesia for comparison of the offset of an atracurium-induced neuromuscular block in an isolated arm to an arm with maintained circulation. The neuromuscular blocking effect of a bolus dose of atracurium 0.5 mg.kg-1 was measured bilaterally using the integrated adductor pollicis EMG response (integrated T1 EMG response in % of baseline value and T4/T1 ratio) after bilateral ulnar nerve train-of-four (TOF) stimulation. At 10% T1 recovery, one arm was isolated from the general circulation for 20 min by means of a tourniquet cuff (isolated arm), while normal circulation was maintained in the other arm (control arm). In both arms, the TOF response, peripheral skin temperature, mixed peripheral venous pH and plasma concentrations of atracurium and laudanosine were then measured and compared. Core and peripheral skin temperatures in both arms remained stable and normal throughout the study, and mixed peripheral venous pH stayed within physiological limits in both arms in all subjects. In the isolated arm, recovery of the neuromuscular block was markedly delayed compared to the control arm, the integrated EMG T1 response and TOF ratio being significantly reduced in the isolated arm after 20 min of isolation. The decline in plasma concentration of atracurium was less in the isolated arm than in the control arm, whereas laudanosine levels increased in the isolated and decreased in the control arm. Normal peripheral circulation is of major importance for termination of an atracurium-induced neuromuscular block.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
L I Eriksson; R H Vandenbrom; C Lennmarken; S Agoston
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  36     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-12-07     Completed Date:  1992-12-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  728-32     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Faculty of Health Sciences, Linköping University, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia Recovery Period
Anesthesia, Intravenous*
Arm / blood supply
Atracurium / administration & dosage,  blood,  pharmacology*
Electric Stimulation
Electromyography
Female
Humans
Ischemia / physiopathology
Isoquinolines / blood
Middle Aged
Muscles / drug effects
Neuromuscular Junction / drug effects*
Perfusion
Skin Temperature / physiology
Synaptic Transmission / drug effects*
Thumb
Tourniquets
Chemical
Reg. No./Substance:
0/Isoquinolines; 2688-77-9/laudanosine; 64228-79-1/Atracurium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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