The ‘New’ Relaxants. A Review of the Clinical Pharmacology of Atracurium and Vecuronium

Abstract

Atracurium and vecuronium are reviewed with reference to the following aspects: Development and chemistry Pharmacology Potency and dosage Onset and duration of action Non-neuromuscular effects Cardiovascular Central nervous system Histamine release and allergic responses Fate in the body Pharmacokinetics Factors which affect response to atracurium and vecuronium Anaesthetic agents Suxamethonium Age Clinical aspects Intubation Cardiac disease and cardiac surgery Renal disease Liver disease Obstetric anaesthesia Anaesthesia for ophthalmic and neurosurgery Intercurrent disease states Outpatient surgery Reversal of neuromuscular block Conclusion