Evaluating cis-atracurium: Comparing different doses for tracheal intubation

Abstract

Objective: This study was designed to compare different doses of cis-atracurium (2×ED95, 4×ED95, 6×ED95) in regarding onset time, condition of intubation , duration of action, hemodynamic effects, and signs of histamine release. Methods: Sixty ASA I and II adult patients undergoing abdominal surgery under general anesthesia were included in this prospective, randomised, double blind study. Patients were allocated to one of three groups: Group 1:Patients in this group received with initial dose of 0.1 mg/kg (2×ED95) of cis- atracurium. Group 2:Received initial dose of 0.2 mg/kg (4×ED95). Group 3:Received initial dose of 0.3 mg/kg (6×ED95). Result: All the demographic parameters were comparable.There was a statistically significant increase in HR, MABP post intubation when compared to baseline and post injection of 2× ED95 dose of cis-atracurium in group 1. Higher doses of cisatracurium (4×ED95 and 6×ED95) showed onset time that was significantly lower than cisatracurium (2×ED95). Regarding the duration of action, higher doses of cisatracurium (4×ED95 and 6×ED95) showed statistically significant longer duration of action than lower doses of cisatracurium.4×ED95 and 6×ED95 doses of cisatracurium were significantly better than 2×ED95 dose of cisatracurium. Only 6×ED95 dose of cisatracurium was statistically significant with higher percentages of patients with excellent condition of intubation. Conclusion: We can conclude that the higher doses of cisatracurium provide more effective, more rapid neuromuscular blocking with longer duration of action, stable hemodynamic status, and no associated signs of histamine release clinically.