A simple feedback control system was used to administer atracurium to 10 infants aged between 5 and 36 months during craniofacial reconstruction. The purpose of the study was to establish whether the system, previously evaluated only in adults, would be effective in paediatric patients. The individuals studied underwent long procedures with substantial blood loss and the potential for thermal and electrolyte disturbances. The system maintained the level of neuromuscular block successfully between 88 and 100% in all patients and between 90 and 100% in nine patients. The mean duration of feedback control was 179 (range 111-440) minutes. The mean (SD) dose of atracurium required was 0.40 (0.12) mg/kg/hour. The mean (SD) recovery time to a train-of-four ratio of 0.75 was 24.8 (9.9) minutes.

Atracurium↗

PubMed1987

Feedback control of neuromuscular blockade. A simple system for infusion of atracurium.

A simple system for closed-loop control of neuromuscular blockade is described. It comprises a Datex Relaxograph, a small relay and a syringe pump. The equipment is commercially available and requires no complex custom-built electronics. Atracurium was infused in a semicontinuous manner to 11 patients who underwent general anaesthesia for a variety of surgical procedures. Neuromuscular blockade oscillated within a narrow range around the preset level. The mean rate of infusion of atracurium was 0.5 mg/kg/hour (SD 0.13). The mean recovery time was 25.5 minutes (SD 7.95).

Adult↗

PubMed1987

Identification of the epidural space.

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Air↗