Complication of Anesthesia
Efficacy of clemastine fumarate in antagonizing atracurium-induced release of histamine in patients undergoing surgery under general anesthesia
Hou Yonghao, Wu Jianbo, Sun Baozhu, Wang Cuiping, Wang Peng, Du Junzhang, Yu Jingui
Published 2016-12-20
Cite as Chin J Anesthesiol, 2016,36(12): 1431-1434. DOI: 10.3760/cma.j.issn.0254-1416.2016.12.005
Abstract
ObjectiveTo evaluate the efficacy of clemastine fumarate in antagonizing atracurium-induced release of histamine in the patients undergoing surgery under general anesthesia.
MethodsEighty American Society of Anesthesiologists physical statusⅠ or Ⅱ patients, aged 21-59 yr, with body mass index of 17-26 kg/m2, scheduled for elective modified radical mastectomy, were divided into 2 groups (n=40 each) using a random number table: control group (group C) and clemastine fumarat group (group CF). Clemastine fumarate 2 mg was injected intramuscularly at 20 min before induction of anesthesia.Anesthesia was induced with iv midazolam 0.1 mg/kg, etomidate 0.3 mg/kg, fentanyl 4-6μg/kg and atracurium 0.8 mg/kg.The patients were mechanically ventilated after insertion of the larygeal mask airway.Anesthesia was maintained with inhalation of 2% sevoflurane.Before administration of clemastine fumarate, at 20 min after administration, immediately before administration of atracurium, and at 2, 5, 10 and 20 min after administration of atracurium, arterial blood samples were taken for determination of plasma histamine concentrations, and the peak airway pressure and degree of cutaneous color were recorded.The development of histaminemia and adverse cardiovascular events was assessed.Steward recovery scores and Ramsay sedation scores were recorded at 10 min after removal of the laryngeal mask airway.
ResultsThe incidence of histaminemia was 60% and 8% in C and CF groups, respectively.Compared with group C, the plasma histamine concentrations, incidence of histaminemia, degree of cutaneous color, and incidence of hypotension and tachycardia were significantly decreased (P<0.05), and no significant change was found in the peak airway pressure, Steward recovery scores and Ramsay sedation scores in group CF (P>0.05).
ConclusionFor atracurium-induced release of histamine in the patients undergoing surgery under general anesthesia, clemastine fumarate 2 mg injected intramuscularly before operation can not only antagonize histamine at H1 level, but also reduce histamine release, and exerts no influence on recovery from anesthesia and produces good antihistamine efficacy.
Key words:
Histamine H1 antagonists; Atracurium; Histamine release; Anesthesia, general
Contributor Information
Hou Yonghao
Department of Anesthesiology, Qilu Hospital of Shandong University, Ji′nan 250012, China
Wu Jianbo
Department of Anesthesiology, Qilu Hospital of Shandong University, Ji′nan 250012, China
Sun Baozhu
Department of Anesthesiology, Qilu Hospital of Shandong University, Ji′nan 250012, China
Wang Cuiping
Department of Anesthesiology, Qilu Hospital of Shandong University, Ji′nan 250012, China
Wang Peng
Department of Anesthesiology, Qilu Hospital of Shandong University, Ji′nan 250012, China
Du Junzhang
Department of Anesthesiology, Qilu Hospital of Shandong University, Ji′nan 250012, China
Yu Jingui
Department of Anesthesiology, Qilu Hospital of Shandong University, Ji′nan 250012, China
