Hoffman’s degradation of Atracurium is Temperature-dependent and pH dependent. Hypothermia and Acidosis are frequently seen hand in hand, in many Prolonged surgeries. Hypothermia impairs Tissue perfusion and causes Acidosis. Hypothermia also REDUCES Tissue perfusion requirement. But when both are present together significantly— It leads to prolongation of Ultrashort acting muscle relaxants. Hypothermia below 27-degree centigrade significantly prolongs the Action of all Muscle relaxants.
Similarly, Acidosis below pH 7.2 Also prolongs. This shud be kept in mind when feeling extremely safe with Atracurium. Reversal of Vecuronium is influenced very less by Temperature and pH. Kindly observe and comment.
