Systemic Vascular Responses to Atracurium during Enflurane–Nitrous-Oxide Anesthesia in Humans

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Abstract
Systemic circulatory responses to atracurium (0.2 and 0.4 mg/kg) were studied in 15 healthy (ASA [American Society of Anesthesiologists] I or II) adult patients during enflurane (1.0-1.25% inspired) and N2O (70% inspired) anesthesia. All patients were premedicated with i.m. morphine (10-15 mg) and glycopyrrolate (0.2 mg). Compared with control measurements during enflurane N2O anesthesia, heart rate, cardiac and stroke index, central venous pressure and systemic mean arterial pressure remained unchanged at 2, 5 and 10 min after administration of both doses of atracurium. Systemic vascular resistance was minimally decreased (7% compared to control) (0.01 < P < 0.05) at 10 min following both doses of atracurium. No patient demonstrated a decrease in systemic mean arterial pressure greater than 6 mm Hg. Atracurium in doses which produce adequate skeletal muscle relaxation during steady-state enflurane anesthesia evidently produces no clinically significant alteration in hemodynamic variables.