SYNERGISM BETWEEN ATRACURIUM AND VECURONIUM IN CHILDREN
Open Access
- 1 September 1993
- journal article
- clinical trial
- Published by Elsevier in British Journal of Anaesthesia
- Vol. 71 (3) , 440-442
- https://doi.org/10.1093/bja/71.3.440
Abstract
In 30 children under balanced anaesthesia, we have determined dose-response curves and maintenance requirement of three dose ratio combinations of atracurium and vecuronium (10: 1, 4:1 or 1.6: 1 on a μg:μg. basis). Neuromuscular block was monitored by adductor poiicis EMG. An equipotent dose ratio (4:1) was most potent, with a mean (SEM) ED95 of atracurium 95 (6) μg kg−1 with vecuronium 24 (1) μg kg−1 The sum of these doses is only 58% of an ED95 value of one agent (P = 0.000 1). The hourly requirement to maintain a 90–95% neuromuscular block was 2.0 (0.1) times an individual ED95 dose of any combination. Recovery index was 8.9 (0.5) min. These results indicate that a combination of atracurium and vecuronium is supra-additive compared with the effects of each drug alone. However, all combinations maintained an intermediate character of neuromuscular block. Combining atracurium with vecuronium may reduce drug requirement by 40%. (Br. J. Anaesth. 1993; 71: 440–442)Keywords
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