Atracurium besylate is a muscle relaxant that is used during some operations and also to help coma patients breathe on ventilators. It is a prescription drug that requires medical training to use. Although atracurium besylate relaxes muscles, it does not have any effect on pain sensation or consciousness.
Atracurium relaxes muscles that are attached to bone. This effect makes the drug useful when a doctor wishes to place a tube in a patient's airway. Relaxed muscles may also be beneficial during other surgical procedures. When a patient is in a coma and cannot breathe, a doctor may also administer the drug so the mechanical ventilator can be more easily tolerated.
The doctor can administer the drug as a direct injection, repeating the dose as necessary to keep the muscles relaxed. It can also be infused slowly with a solution of the drug to deliver a steady dose of relaxant to the patient, which is useful for prolonged operations. The drug is always used along with anesthestic drugs as it does not put the patient to sleep or give him any pain relief. A continuous infusion of atracurium using a low dosage is useful for coma patients with ventilators.
The recommended initial dose of the drug ranges from 0.3 milligrams per kilogram (mg/kg) of body weight up to 0.6 mg/kg. The drug needs to be injected or infused into a vein and should not be injected into a muscle. An initial dose may take only 90 seconds to have an effect on the muscles and can last for up to 35 minutes. After this time, the doctor may administer more atracurium besylate in smaller doses to maintain the muscle relaxant effect.
The drug is suitable for adults and children over the age of one month. Kids under the age of two and people with conditions such as asthma or allergies may be given lower initial doses. The drug may have an effect on histamine release and trigger allergic reactions in these patients.
Other potential side effects of atracurium besylate include skin rash, itching, and a localized allergic reaction at the site of injection. The drug may also have an effect on heart rhythms, produce low blood pressure, and cause flushing of the skin. The lung muscles may also go into spasm. According to the U.S. National Institutes of Health, these side effects occur in about one in 500 patients. An overdose of the drug may also lengthen the amount of time a patient takes to recover from the relaxant, and the doctor must then artificially ventilate the patient.