Acta anaesthesiologica Belgica
-
Acta Anaesthesiol Belg · Jan 1997
ReviewUse of intermediate acting muscle relaxants by infusion: the future.
The usefulness of newer intermediate-acting muscle relaxants rocuronium and cisatracurium when used by infusion has been reviewed briefly and their main features pointed out. Comparative features of atracurium, vecuronium and mivacurium have also been described. Both new agents may have advantages for use by infusion particularly for longer procedures, due to the lack of detectable metabolites with rocuronium and production of comparatively smaller amounts of metabolites with cisatracurium.
-
Pharmacokinetic and dynamic drug description aim to optimize drug dosing to a desired duration and intensity of effect. In anesthesia practice the therapeutic window is narrow and versatile. Rapid adjustments and rapid reversal of drug effect are mandatory. ⋯ Hysteresis in the concentration-affect relationship is responsible for the lag time between plasma drug concentration and effect. Hysteresis delays initiation of effect as well as recovery from effect. The development of microprocessor aided infusion devices will simplify and ameliorate to a significant extend, the sound application of intravenous drugs in anesthesia.