ABSTRACT
The aim of this study was the comparison of infusion vs. intermittent bolus administration of cisatracurium [CA] following cardiac surgery with regard to total intraoperative dose and time of recovery from neuromuscular blockade. From June 2005 to April 2006 sixty ASA II-III patients who were undergoing coronary bypass graft and valve replacement surgery, were equally divided and randomized to receive either intermittent bolus [Group A, n = 30] or continuous infusion [Group B, n = 30] of CA in Madani Heart Center in the Tabriz [Iran]. Total intraoperative dose of CA and time to TOF ratio = 0.8 after operation were measured. Anesthesia technique in two groups was the same. All of the patients underwent cardiopulmonary bypass. Intensity of neuromuscular blockade maintained on one train-of-four [TOF] twitch response of adductor pollicis during operation. Mean received dose of CA was 32.8 +/- 20.6 micro/kg/hr in Group A and 89.7 +/- 39.4 micro/kg/hr in Group B [p = 0.003]. Total intraoperative dose of CA was 23.6 +/- 4.9 mg in Group A and 39.2 +/- 10.1 mg in Group B [p = 0.001]. Spontaneous recovery from neuromuscular blockade in ICU [TOF ratio = 0.8] was reached in 43.8 +/- 9.2 min in Group A, and 64.2 +/- 15.1 min in Group B [p = 0.0001]. Intubation time in ICU was not significantly different [Group A = 8.3 +/- 5.1 hrs vs. Group B = 10.2 +/- 6.2 hrs, p = 0.256]. These results support the intermittent bolus administration of cisatracurium in cardiac surgery following cardiopulmonary bypass