Korean J Anesthesiol.  2006 Aug;51(2):233-235. 10.4097/kjae.2006.51.2.233.

General Anesthesia using Atracurium for Patient with Acute Organophosphate Poisoning: A case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea. ane84@cnuh.co.kr

Abstract

A 53-year-old man ingested insecticide and stabbed himself in the upper abdomen in an attempt to commit suicide. He presented with nausea, vomiting, excessive salivation and urination as a result of organophosphate poisoning upon admission. He was planned to undergo an exploratory laparotomy under general anesthesia. After placing a neuromuscular monitor, atracurium 10 mg three times before intubation and additional 5 mg bolus were administered when the third twitch appeared during operation. The total dose of atracurium administered was 50 mg, and the total duration of anesthesia was 150 minutes. The patient was not extubated despite the adequate recovery from atracurium in order to protect the sutured liver and there being some concern of the intermediate syndrome. In the intensive care unit, atropine was discontinued 37 hours after poisoning. The patient was extubated successfully 48 hours after poisoning and was kept under close observations on respiration and supportive care. He was discharged 12 days after surgery without any sequela.

Keyword

atracurium; general anesthesia; organophosphate; poisoning

MeSH Terms

Abdomen
Anesthesia
Anesthesia, General*
Atracurium*
Atropine
Humans
Intensive Care Units
Intubation
Laparotomy
Liver
Middle Aged
Nausea
Organophosphate Poisoning*
Poisoning
Respiration
Salivation
Suicide
Urination
Vomiting
Atracurium
Atropine
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