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British Journal of Anaesthesia, 1985, Vol. 57, No. 2 160-168
© 1985 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

USE OF ATRACURIUM AND VECURONIUM IN PATIENTS WITH OESOPHAGEAL VARICES

C. F. BELL, M.B., F.F.A.R.C.S., J. M. HUNTER, M.B., F.F.A.R.C.S., R. S. JONES, DR., MED. VET., F.R.C.V.S. and J. E. UTTING, M.A., M.B., F.F.A.R.C.S.

University Department of Anaesthesia 4th Floor, Royal Liverpool Hospital, Prescot Street, P.O. Box 147, Liverpool L69 3BX

Correspondence to J.M.H.

The effects of atracurium (initial dose 0.5 mgkg–1; incremental doses 0.2 mg kg–1) and vecuronium (initial dose 0.1 mg kg–1; incremental doses 0.04 mg kg–1) are described in patients with portal hypertension and some degree of liver dysfunction, and the findings compared with those from normal patients. With these doses there was no evidence of gross resistance to the two neuromuscular blockers in the patients with liver problems, although the duration of action of the initial dose was somewhat shorter, and the same may have been true of incremental doses. The method of elimination would suggest that atracurium may be the better drug in patients with severe liver dysfunction, but the use of small doses of vecuronium is not contraindicated in this type of patient.


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