Atracurium infusion in the intensive care unit.

An open study of 38 infusions of atracurium in 33 patients requiring neuromuscular blockade for ventilation was carried out. Consecutive patients requiring ventilation were studied and there were no exclusions. The initial rate of infusion was 0.4 mg kg-1 h-1 and this was adjusted according to clinical observation and the results of neuromuscular stimulation. The average infusion rate in the series was 0.59 mg kg-1 h-1. Patients were sedated using a morphine infusion at a rate of 2-4 mg kg-1 h-1. Satisfactory blockade was achieved in all cases. Time for spontaneous recovery following termination of infusion was recorded, the average recovery time being 39.2 min. Emphasis was placed on recording any possible serious toxic effects attributable to long-term atracurium infusions, possible toxic effects were considered and a satisfactory explanation of such effects was found in all cases.