The effect of induced hypothermia on the duration of action of atracurium when given by infusion to critically ill children

The aim of the study was to investigate the effect of induced hypothermia o n the offset time of atracurium when given by continuous infusion to critic ally ill children. Over a period of 8 months, six mechanically ventilated c hildren had a steady-state infusion of atracurium discontinued. The offset time of atracurium was assessed by train-of-four (TOF) stimulation of the u lnar nerve; recording the time taken to reach a TOF ratio of 0.9. Nine asse ssments were carried out. The mean offset time of atracurium was 82 min. Th is was significantly longer than in patients with temperatures within the n ormal physiological range. When considering all assessments, performed both in hypothermic and normothermic patients, there is a strong correlation be tween rectal temperature and the offset time of atracurium. Prolonged moder ate hypothermia has a very significant effect on the offset time of atracur ium when given by infusion to critically ill children.