Patients with burns are resistant to atracurium

Abstract

A normal response to intubating doses of atracurium is obtained in burned patients with less than 33% TBSA burn, and in patients with any sized burn less than 6 days postinjury. Patients 6 days postburn with greater than 33% TBSA thermal injury show increased requirements for atracurium proportional to the size of burn. This resistance is maximal at 15 to 40 days, is attenuated by 100 days, but some resistance may be present for as long as 500 or more days.