Exploration of cisatracurium for tracheal intubation with the best priming and intubation dose / 中国医师进修杂志

ABSTRACT

Objective To observe different priming techniques with intubation dose when using cisatracurium in onset time and safety. Methods Eighty ASA physical status Ⅰ and Ⅱ patients undergoing elective surgery requiring general anesthesia were enrolled. Group Ⅰ with 20 cases received cisatracurium 0.010 mg/kg, group Ⅱ with 20 cases received cisatracurium 0.015 mg/kg,group Ⅲ with 20 cases received cisatracurium 0.010 mg/kg,and group Ⅳ with 20 cases received normal saline. Four minutes after priming,group Ⅰ received cisatracurium 0.140 mg/kg ,group Ⅱ received cisatracurium 0.135 mg/kg, group Ⅲ received cisatracurium 0.190 mg/kg,and group Ⅳ received cisatracurium 0.200 mg/kg. Mechanomyography assessed the neuromuscular function of the adductor pollicis with train-of-four (TOF) supramaximal impulses T1. The trachea was intubated when the amplitude of T1 decreased to 0. Recorded T1 and TOF in 4 minutes and onset time of muscle relaxation, then evaluated intubation condition. Results The onset time in group Ⅰ , Ⅱ, Ⅲ and Ⅳ were (151.30 ± 10.90), (138.90 ±8.37), (145.45 ± 17.12), (148.75 ± 18.70) s,respectively. The onset time in group Ⅱ was obviously shorter than that in group Ⅰ , Ⅲ and Ⅳ (P ＜ 0.01 ),thus there was no significant differences among the group Ⅰ , Ⅲ and Ⅳ. During the priming interval, the value of T1 and TOF were both showing downtrend, in group Ⅱ ,there was TOF ＜ 90%. Conclusions Priming dose 0.010 mg/kg and intubation dose 0.140 mg/kg is just the same like that in intubation dose of quadruple ED95 whether priming. There is no benefit in priming cisatracurium of intubation dose quadruple ED95. There is TOF ＜ 90% in 4 minutes priming interval when using priming dose 30% ED95 and it is proved unsafely.