Intubating conditions following 1R CIS, 1′R CIS atracurium (51W89)

51W89 besylate, a new intermediate acting non‐depolarising muscle relaxant, consisting of a single stereo‐isomer of the commercial preparation of atracurium has been assessed in respect of intubating conditions during nitrous oxide‐propofol‐isoflurane anaesthesia. Intubating conditions at 2min were acceptable in 67% of patients following a dose of 0.1 mg.kg‐1 and in 90% of patients following a dose of 0.15 mg.kg‐1. Intubating conditions at 1.5 min were acceptable in 76% of patients following a dose of 0.2mg.kg‐1. In comparison, intubating conditions at 2min were acceptable in 95% of patients following 0.5mg.kg‐1 of atracurium. The intubating conditions at 2 min following a dose of 0.1 mg.kg‐1 51W89 besylate were significantly worse than the other three groups (p < 0.05); however, there was no significant differences between the scores in the other three groups. There was no clinical evidence of histamine release in the groups receiving 51W89 besylate compared to two out of the 19 patients who had cutaneous flushing following the administration of atracurium. Our results suggest that 51W89 besylate provides acceptable intubating conditions at 2 min following a dose of 0.15 mg.kg‐1 and may prove to be an acceptable alternative to atracurium if studies in progress confirm its greater cardiovascular stability and reduced propensity to release histamine than its parent compound.

[1]  R. Mirakhur,et al.  Neuromuscular effects and intubating conditions following mivacurium: a comparison with suxamethonium , 1993, Anaesthesia.

[2]  M. Dinner,et al.  Succinylcholine Increases Intraocular Pressure in the Human Eye with the Extraocular Muscles Detached , 1993, Anesthesiology.

[3]  A. R. Cooper,et al.  Myalgia and biochemical changes following suxamethonium after induction of anaesthesia with thiopentone or propofol , 1993, Anaesthesia.

[4]  R. Meikle,et al.  Intubation with propofol: evaluation of pre-treatment with alfentanil or lignocaine. , 1993, European journal of anaesthesiology.

[5]  R. M. Jones,et al.  Mivacurium chloride: a study to evaluate its use during propofol–nitrous oxide anaesthesia , 1992, Anaesthesia.

[6]  D. Goldhill,et al.  Neuromuscular and clinical effects of mivacurium chloride in healthy adult patients during nitrous oxide-enflurane anaesthesia. , 1991, British journal of anaesthesia.

[7]  S. Kallar A22 PROPOFOL ALLOWS INTUBATION WITHOUT RELAXANTS , 1990 .

[8]  J. Dundee,et al.  The effects of thiopentone and propofol on upper airway integrity , 1988, Anaesthesia.

[9]  F. Donati Onset of action of relaxants , 1988, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[10]  J. Keaveny,et al.  Intubation under induction doses of propofol , 1988, Anaesthesia.

[11]  G. Graham,et al.  The Pharmacokinetics of Atracurium Isomers In Vitro and in Humans , 1987, Anesthesiology.

[12]  G. Lavery,et al.  Atracurium in clinical anaesthesia: effect of dosage on onset, duration and conditions for tracheal intubation , 1985, Anaesthesia.

[13]  J. Dundee,et al.  CLINICAL EVALUATION OF ORG NC 45 , 1983 .

[14]  D. Newton,et al.  The neuromuscular blocking action of ORG NC 45, a new pancuronium derivative, in anaesthetized patients. A pilot study. , 1980, British journal of anaesthesia.

[15]  R. Kitz,et al.  Does clinical anesthesia need new neuromuscular blocking agents? , 1975, Anesthesiology.