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British Journal of Anaesthesia, 1986, Vol. 58, No. suppl_1 96S-102S
© 1986 The Board of Management and Trustees of the British Journal of Anaesthesia

other

Atracurium Infusion in Liver Transplantation

J. V. Farman, M.B.B.S., F.F.A.R.C.S., J. M. Turner, M.B., CH.B., F.F.A.R.C.S. and Y. Blanloeil, M.D.

Addenbrookes' Hospital Cambridge CB2 2QQ

Abstract

A continuous infusion of atracurium was used to provide neuromuscular blockade in 25 adult patients undergoing liver transplantation following atracurium, suxamethonium or vecuronium for intubation. Blockade was monitored by recording evoked electromyographic response and maintained with a mean infusion rate of 0.38 ± 0.14 mg kg–1 h–1 during 306±80 min of operation. Atracurium requirements appeared to be less during the anhepatic period and greater after removal of the vascular clamps on the new liver. No instances of arterial hypotension or anaphylactoid reactions attributable to atracurium were reported. It can be concluded that a continuous infusion of atracurium is a safe, effective and convenient technique of ensuring neuromuscular blockade during liver transplantation, at a rate of infusion no different from that needed in patients with normal hepatic function.

Footnotes

* Present address: Hopital Guillaume et Rene Laennec, B.P. 1005-Names Cedex, France


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