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

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.