아트라쿠륨 베실산염

Atracurium Besylate

Atracurium besylate

다른 이름: Tracrium · Abbottracurium · Faulcurium · Ifacur · Laurak · Mycurium · Relatrac · Sitrac · Trablok · 33A74 · atracurium besilate · BW-33A

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

0.2 mg/kg IV initial dose; subsequent doses 0.1 mg/kg IVIV· every 20-30 minutes

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
Critically ill patients when low concentrations of, or no inhalant anesthesia can be used	0.2 mg/kg IV initial dose; subsequent doses 0.1 mg/kg IV	IV	every 20-30 minutes	—	🌎 NA
Neuromuscular blockade augmentation during corneal surgery	0.15 mg/kg IV	IV	Single dose	—	🌎 NA
Muscle relaxant to facilitate intubation in patients with severe blunt trauma	0.25 mg/kg IV push	IV	Single dose	—	🌎 NA
Induction of respiratory muscle paralysis during mechanical ventilation	Loading dose: 0.2-0.5 mg/kg IV, then a constant rate infusion 5 minutes later of 3-9 micrograms/kg/min	IV	CRI	—	🌎 NA

Critically ill patients when low concentrations of, or no inhalant anesthesia can be used: Do not dose more frequently than every 20-30 minutes unless a peripheral nerve stimulator is applied, or voluntary movement is observed. Positive pressure ventilation required.
Muscle relaxant to facilitate intubation in patients with severe blunt trauma: Given if patient requires intubation after IV acepromazine (0.01 mg/kg) + butorphanol (0.1 mg/kg) + ketamine (1 mg/kg).
Induction of respiratory muscle paralysis during mechanical ventilation: Use D5W or 0.9% sodium chloride for diluent; do not mix with other drugs. Respiratory and cardiovascular monitoring should be provided.

고양이

적응증	용량	경로	빈도	기간	지역
Induction dose	0.22 mg/kg IV	IV	Single dose	—	🌎 NA
Intraoperative dose	0.11 mg/kg IV	IV	As needed	—	🌎 NA
Induction of respiratory muscle paralysis during mechanical ventilation	Loading dose: 0.2-0.5 mg/kg IV, then a constant rate infusion 5 minutes later of 0.37 micrograms/kg/min	IV	CRI	—	🌎 NA
Critically ill patients when low concentrations of, or no inhalant anesthesia can be used	0.2 mg/kg IV initial dose; subsequent doses 0.1 mg/kg IV	IV	every 20-30 minutes	—	🌎 NA

Induction dose: Give 1/10th to 1/6th of this dose initially as a 'priming' dose, followed 4-6 minutes later with the remainder and a sedative/hypnotic agent.
Induction of respiratory muscle paralysis during mechanical ventilation: Use D5W or 0.9% sodium chloride for diluent; do not mix with other drugs.
Critically ill patients when low concentrations of, or no inhalant anesthesia can be used: Do not dose more frequently than every 20-30 minutes unless a peripheral nerve stimulator is applied. Positive pressure ventilation required.

소형 포유류

적응증	용량	경로	빈도	기간	지역
Paralysis for periophthalmic surgery (Rabbits)	0.1 mg/kg	IV	Single dose	—	🌎 NA

말

적응증	용량	경로	빈도	기간	지역
Intraoperative dose	0.055 mg/kg IV	IV	As needed	—	🌎 NA

Intraoperative dose: Note: ARCI UCGFS Class 2 Drug. Atracurium is more potent in horses than in other species.

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개요

아트라쿠륨은 전신 마취의 보조제로 주로 사용되는 널리 활용되는 비탈분극성 신경근 차단제입니다. 외과적 수술, 기관 내 삽관 및 기계적 환기를 용이하게 하기 위해 깊은 골격근 이완을 제공합니다.

핵심 임상 정보:

장기 독립적 배출: 아트라쿠륨은 호프만 제거(Hofmann elimination) 및 에스테르 가수분해를 통해 대사되므로 심각한 신장 또는 간 질환이 있는 환자에게 매우 유용합니다.
진통 또는 진정 효과 없음: 환자를 마비시키지만 통증 완화나 의식 소실을 전혀 제공하지 않습니다. 절대 단독 약물로 사용해서는 안 됩니다.
심혈관계 안정성: 표준 용량에서 기존의 신경근 차단제에 비해 심혈관계에 미치는 영향이 최소화되지만, 간혹 히스타민 방출을 유발할 수 있습니다.
종 특이적 민감성: 이 약물은 다른 종에 비해 말에서 특히 더 강력한 효능을 나타냅니다.

작용 기전

Atracurium acts by competitively binding to nicotinic cholinergic receptors at the motor end-plate of the neuromuscular junction.

By occupying these receptors, it prevents acetylcholine (ACh) from binding → inhibits depolarization of the muscle cell membrane → results in flaccid paralysis of skeletal muscles.

Because it is a competitive antagonist, its effects can be reversed by increasing the concentration of ACh at the neuromuscular junction (e.g., by administering acetylcholinesterase inhibitors like neostigmine or edrophonium).

안전성·주의사항

금기사항

Hypersensitivity to atracurium
Relative contraindication: Myasthenia gravis
Lack of ventilatory support (must have mechanical ventilation available)

부작용

Allergic reactions
Inadequate or prolonged neuromuscular block
Hypotension
Vasodilation
Bradycardia
Tachycardia
Dyspnea
Bronchospasm
Laryngospasm
Rash
Urticaria
Injection site reaction

주의

CRITICAL WARNING: Atracurium has NO analgesic or sedative/anesthetic actions. Patients must be appropriately sedated/anesthetized and provided with analgesia.

Ventilation: Positive pressure ventilation (preferably mechanical) is absolutely required when using this drug.
Histamine Release: May rarely cause significant histamine release; use with caution in patients where this would be hazardous (e.g., severe cardiovascular disease, asthma).
Myasthenia Gravis: Use with extreme caution, or not at all, in patients suffering from myasthenia gravis.
Vagal Tone: Has minimal cardiac effects and will not counteract bradycardia or vagal stimulation induced by other anesthetic agents.

약물 상호작용

Aminoglycoside antibiotics (e.g., gentamicin)

May enhance the neuromuscular blocking activity of atracurium

General anesthetics (enflurane, isoflurane, halothane, sevoflurane)

May enhance and prolong the neuromuscular blocking activity

Bacitracin, Polymyxin B (systemic)