Ah. Boyd et al., PHARMACODYNAMICS OF THE 1R CIS-1'R CIS ISOMER OF ATRACURIUM (51W89) IN HEALTH AND CHRONIC-RENAL-FAILURE, British Journal of Anaesthesia, 74(4), 1995, pp. 400-404
We have studied the pharmacodynamics of the 1R cis-1'R cis isomer of a
tracurium (51W89) in 15 healthy subjects and in 17 patients with chron
ic renal failure using a bolus dose of 51W89 0.1 mg kg(-1) (2 x ED(95)
). Fifteen patients with normal renal function were investigated also
using an approximately equipotent dose of atracurium (0.4 mg kg(-1)).
The compound surface action potential of the adductor pollicis muscle,
in response to train-of-four stimulation of the ulnar nerve at the wr
ist, was recorded until recovery of the height of the first response o
f the train-of-four compared with baseline (T1:T0) had reached at leas
t 85% and the train-of-four ratio (T4:T1) at least 80%. In the healthy
and renal failure patients who received 51W89, there were no signific
ant differences in any of the onset or recovery variables except for t
he time to 90% depression of T1:T0, which was longer in patients with
renal failure (mean 3.7 min vs 2.4 min; P < 0.05). Of the healthy pati
ents who were given either 54W89 or atracurium, there were no signific
ant differences in the onset data, except for time to maximum block, w
hich was longer in the 51W89 group (mean 7.7 min vs 6.2 min; P < 0.01)
. The mean times to 10%, 25%, 50% and 75% recovery of T1:T0 and the ti
me for T4:T1 > 70% were significantly longer in patients receiving 51W
89. We conclude that 51W89 has an intermediate duration of action whic
h was not significantly affected by the presence of chronic renal fail
ure. In healthy patients, recovery from 51W89 may take slightly longer
than that after atracurium.