CISATRACURIUM IN DIFFERENT DOSES VERSUS ATRACURIUM DURING GENERAL ANESTHESIA FOR ABDOMINAL SURGERY A PROSPECTIVE, RANDOMIZED CLINICAL TRIAL

Dr Mridu Paban Nath, Dr Avishrant Gogoi

Abstract


Background and objective: This study was aimed at comparing the efficacy of atracurium and cisatracurium (in different doses) regarding onset time, intubating conditions and hemodynamic effects in patients undergoing elective abdominal surgery.

Methods: - This Randomized, double-blind, single Hospital, Prospective study, was carried out after institutional ethical committee clearance. Hundred and twenty patients aged 18 to 60 years belonging to ASA classes I and II undergoing, elective abdominal surgery were randomly allocated into 3 groups- Group A (n=40): Inj cisatracurium 0.1 mg/kg(2 ED 95),Group B(n=40): Inj Cisatracurium 0.15mg/kg(3 ED 95) and Group C(n=40): Inj Atracurium 0.5mg/kg(2 ED 95). Onset time, Intubating conditions and hemodynamic parameters were compared between the 3 groups.

Results: The demographic parameters and baseline hemodynamic variables were comparable and statistically not significant. The intubating condition and onset time of Group A when compared to Group B and Group C were statistically significant, whereas in-between Group B and C were nonsignificant. Hemodynamic parameters at 0,1,3,5 mins after intubation were comparable and nonsignificant.

Conclusion: From our clinical comparative study, we have observed that intubating conditions with 3 ED 95 cisatracurium and 2 ED 95 atracurium are comparable and significantly better than 2 ED 95 cisatracurium. The onset time in 2 ED 95 Cisatracurium was significantly longer when compared to 3 ED 95 cisatracurium and 2 ED95 Atracurium. No significant hemodynamic changes were noted in any of the three groups.


Keywords


Cisatracurium, atracurium, different ED95 dose and neuromuscular monitoring

Full Text:

PDF

References


Ali HH, Savarese JJ. Monitoring of neuromuscular function. Anesthesiology 1976; 45: 216-49.

Barve M, Sharma R. Intubating conditions with Rocuronium br. & Succinylcholine in paediatric patients.Indian J. anaesth. 2002;46 (6) : 465-8

Bartkowski RR, Witknowski TA, Azad S,Lessin J and Marra . Rocuronium onset ofaction: a comparison with atracurium andvecuronium. Anesthesia &Analgesia.1993; 77(3): 574-8.

Haines M. Comparison of onset time,duration of action and fade characteristics of atracurium and vecuronium. ANNAJ.1993; 61(6): 592-6

Yazdanian f.,ghandi i.,toutounchi z.,comparison of hemodynamic effects of atracurium and cisatracurium in patients undergoing coronary artery bypass grafting. Journal of iranian society anaesthesiology and intensive care 2008 ,Volume 30 , Number 61; Page(s) 56- 66

Bergeron L, Bevan DR, Berrill A, Kahwaji R, Varin F: Concentration-effect relationship of cisatracurium at three different dose levels in the anesthetized patient. Anesthesiology 95 314-23, 2001.

Shang Guan, WangNing; Lian, Qing Quan; Li, Jun; Gao, Fang Clinical pharmacology of cisatracurium during nitrous oxide-propofol anesthesia in children. Journal of Clinical Anesthesia 20.6 (2008): 411-4.

Smith CE, van Miert MM, Parker CJ, Hunter JMA comparison of the infusion pharmacokinetics and pharmacodynamics of cisatracurium, the 1R-cis 1'R-cis isomer of atracurium, with atracurium besylate in healthy patients. Anaesthesia. 1997 Sep;52(9):833-41.)

Cooper, R., Mirakhur, R. K., Clarke, R. S. J. & Boules, Z. Comparison of intubating conditions after administration of org 9426 (rocuronium) and suxamethonium. Br. J. Anaesth. 69, 269–273 (1992).

Haridas, R. P. Earliest English Definitions of Anaisthesia and Anaesthesia. Anesthesiology 127, 747–753 (2017

A New English Dictionary on Historical Principles, volume 1. Edited by Murray JAH. Oxford, Clarendon Press, 1884–1928,p 301

Haridas, R. P. William TG Morton’s early ether inhalers: A tale of three inhalers and their inscriptions. Anaesthesia and Intensive Care (2009);37.

Mellinghoff H , Radbrush L, Diefenbach C, Buzello W.A comparison of cisatracurium and atracurium :onset of neuromuscular block after bolus injection and recovery after subsequent infusion, Anaesthanalg 1996;83:1072-5.

Bluestein, L. S., Stinson, L. W., Lennon, R. L., Quessy, S. N. & Wilson, R. M. Evaluation of cisatracurium, a new neuromuscular blocking agent, for tracheal intubation. Can. J. Anaesth. 43, 925–931 (1996).

El-Kasaby, A. M., Atef, H. M., Helmy, A. M. & El-Nasr, M. A. Cisatracurium in different doses versus atracurium during general anesthesia for abdominal surgery. Saudi J. Anaesth. 4, 152–157 (2010).


Refbacks

  • There are currently no refbacks.