Abstract
The effect of atracurium on intracranial pressure (ICP) was investigated in six cats with normal and increased ICP. The cats were anaesthetized with intraperitoneal pentobarbitone (33mg·kg-1), acepromazine (0.6mg·kg-1) and incremental fentanyl (p.r.n.≅ 20μg·kg-1), intubated, and ventilated with nitrous oxide in oxygen. Mean arterial pressure (MAP), heart rate (HR), twitch response and ICP were continuously recorded. After the effect of atracurium had been ascertained under the condition of normal ICP, and after full recovery of twitch response, pH-adjusted Ringer’s lactate solution was infused into the cisterna magna until an ICP baseline of 26 ±2 mmHg was established and stabilized. Atracurium was then administered again to determine its effect under the condition of elevated ICP. Complete ablation of twitch response was obtained in 68 ± 15 sec with 0.4 mg·kg-1 atracurium, and there was no significant change in ICP, MAP, HR or cerebral perfusion pressure (CPP) whether initial ICP was normal or elevated.
Résumé
Les ejfets de l’atracurium sur la pression intracrânienne (ICP) ont été investigués sur six chats présentant une pression intracrénienne normale ou élevée. Les chats ont été anesthésié avec du pentobarbitone (33mg·kg-1) administré par voie péritoniale, l’acepromazine (0.6 mg·kg-1) et des doses additionnelles de fentanyl (p.r.n. ≅ 20 μg·kg-1), intubés et ventilés avec le protoxide d’azote dans l’oxygène. La pression artérielle moyenne (MAP) fréquence cardiaque (HR), réponse neuromusculaire, et la pression intracrânienne ont été enregistrés d’une façon continue. Après létablissement des effets de l’atracurium lors d’ une pression intracrânienne normale ainsi qu’après le rétablissement de la fonction neuromusculaire, les solutions de lactate Ringer’s à pH-ajusté a été injectés dans la grande citerne jusqu’ à l’obtention de la pression intracrânienne de base de 26 ± 2 mmHg. L’atracurium a été ensuite administré afin de déterminer son ejfet dans des conditions d’une pression intracrânienne élevée. L’abolition complète des contractions a été obtenu après 68 ± 15 sec avec 0.4mg·kg-1 d’atracurium. Aucun changement significatif n’a été observé dans la pression intracrânienne, la pression artérielle moyenne à fréquence cardiaque ou la pression de perfusion cérébrate (CPP) lorsque la pression intracrânienne était normale ou élevé.
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References
Savarese JJ, Kitz RJ. Does clinical anesthesia need new neuromuscular blocking agents? Anes- thesiology 1975; 42:236–9.
Supplement 1: Introduction - Atracurium. Br J Anaesth l983; 55: 3S–103S.
Payne JP, Hughes R. Evaluation of atracurium in anaesthetized man. Br J Anaesth 1981; 53:45–54.
Basta SJ, Savarese JJ, Ali HH et al. Clinical pharmacology of atracurium besylate (BW 33A): a new nondepolarizing muscle relaxant. Anesth Analg 1982; 61:733–9.
Hughes R, Chappie DJ. The pharmacology of atracurium; a new competitive neuromuscular blocking agent. Br J Anaesth 1981; 53:31–44.
Hunter JM, Jones R, Utting JE. Use of atracurium during general surgery monitored by the train of four stimuli. Br J Anaesth 1982; 54:1243–50.
Basta SA, Savarese JJ. Comparative histamine- releasing properties of vecuronium, atracurium, tubocurarine and metocurine. Clinical Experience with Norcuron, Excerpta Medica Current Clinical Practice Series 1983; 11:183–4.
Sokoll MD, Gergis SD, Mehta M, Ali NM, Lineberry C. Safety and efficacy of atracurium (BW33A) in surgical patients receiving balanced or isoflurane anesthesia. Anesthesiology 1983; 58:450–5.
Robertson EN, Booij LHDJ, Fragen RJ, Crul JF. Clinical comparison of atracurium and vecuronium. Br J Anaesth 1983; 55:125–9.
Stirt JA, Murray AL, Katz RL, Schehl DL, Chingmuh L. Atracurium during halothane anaesthesia in humans. Anesth Analg 1983; 62:207–10.
Hunt PCW, Cotton BR, Smith G. Comparison of the effects of pancuronium and atracurium on the lower esophageal sphincter. Anesth Analg 1984; 63:65–8.
Fox MA. Atracurium in normal doses may release histamine. (letter) Anesthesiology 1984; 60:386.
McLeskey CH,Cullen BF, Kennedy RD et al. Control of cerebral perfusion pressure during induction of anaesthesia in high-risk neurosurgical patients. Anesth Analg 1974; 53:985–92.
Cornell JE, Hartung J, Giffin JP, Shwiry B. Intra- cranial and hemodynamic changes after succinyl- choline administration in cats. Anesth Analg 1983; 62:1006–9.
Tarkkanen L, Laitinen L, Johansson G. Effects of d-Tubocurarine on intracranial pressure and thalamic electrical impedance. Anesthesiology 1974; 40:247–51.
Cornell JE, Hartung J, Giffin JP. Reply to Lam and Gelb’s. “Succinylcholine and intracranial pressure - a cause for ‘pause’. ” Anesth Analg 1984; 63:620–2.
Hutchinson JD, Pinnock CA. A use of atracurium infusion. Anaesthesia 1984; 39:72.
Stoelting RK. Hemodynamic effects of pancuronium and d-tubocurarine in anesthetized patients. Anesthesiology 1972; 36:612.
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Giffin, J.P., Litwak, B., Cottrell, J.E. et al. Intracranial pressure, mean arterial pressure and heart rate after rapid paralysis with atracurium in cats. Can Anaesth Soc J 32, 618–621 (1985). https://doi.org/10.1007/BF03011408
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DOI: https://doi.org/10.1007/BF03011408