A Prospective Randomised Study Comparing Neuromuscular Blockade And Recovery Characteristics Of Two Different Doses Of Cis - Atracurium Versus Atracurium In Elective Surgeries

ABSTRACT

Background:Cisatracurium is the stereoisomer of atracurium but has considerably higher neuromuscular blocking potency, better hemodynamic profile and no association with dose-dependent histamine release, as compared with the parent compound(1)(2,3). On the other hand, 2 ED95dose s of cis-atracurium (100? g/kg) do not create satisfactory intubating conditions such as those seen with equipotent doses of atracurium.There are limited studies which provide us the clarity of a better neuromuscular blocker in terms of intubation and maintainence amongst the two with the most optimum dose. Material And Methods:The study designed as randomised controlled trial, recruited 150 patients into three groups Group A-atracurium 0.5 mg/kg(2×ED95), Group B and C-cis-atracurium 0.2 mg/kg (4×ED95) and 0.4 mg/kg (8×ED95)respectively and compared them on the basis of onset, duration of action, recovery time, haemodynamic effect and signs of histamine release clinically. Result:Patients in Group C had significantly shorter onset time of block when c ompared with group A & B. Mean duration of block after loading dose was significantly shorter in Group A than group B & C. Group B had a shorter duration of block than C. Recovery time of block in group A was significantly shorter than group B & C. Conclusion:Cis-atracurium in dose of 0.2 mg/kg seems to be better alternative to atracurium 0.5 mg/kg and cis-atracurium 0.4 mg/kg in providing faster onset, intermediate duration of action with fast recovery and it can be used for intubation as well as maintenance.