The pharmacokinetics of d-tubocurarine with surgery involving salvaged autologous blood

C. A. Shanks, M. J. Avram, A. K. Ronai, D. J. Bowsher

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

The disposition of d-tubocurarine (dTc) was assessed when a bolus and infusion dosage regimen was used to obtain relaxation during major orthopedic surgery on the spine. Renal clearance of dTc was 0.63 ± 0.23 ml.min-1.kg-1 and was correlated with creatinine clearance. Total plasma clearance of 1.21 ± 0.40 ml.min-1.kg-1 was lower than that found in many previous studies, and the predetermined continuous dTc infusion produced an apparent plateau in plasma concentrations of 1.8 ± 0.3 μg.ml-1. Despite the operative blood loss, these concentrations were greater than anticipated and were associated with a more intense neuromuscular blockade than the infusion was designed to produce. Autologous blood transfusion was used to reduce the reliance on homologous donor blood, and the erythrocytes from the 2.2 ± 1.2 l of blood loss during the procedure were reinfused after intraoperative salvage, washing, and centrifugation. With 80 ± 23 mg dTc administered, 1.4 ± 0.8% was recovered from the fluid discarded after centrifugation. These results indicate that even massive intraoperative blood loss will not entail a significant reduction in the amount of dTc present in the body.

Original languageEnglish (US)
Pages (from-to)161-165
Number of pages5
JournalAnesthesiology
Volume62
Issue number2
DOIs
StatePublished - 1985

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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