Evaluation of neuromuscular blocking effect of cisatracurium in patients with liver cirrhosis

ABSTRACT

Cisatracurium is one of the ten stereoisomers of atracurium, it is a potent intermediate duration non-depolarizing neuromuscular blocking agent. and its pharmacokinetics and pharmacodynamics are similar to atracurium. it is degraded in plasma by Hofmann degradation and ester hydrolysis. In this study we evaluated its neuromuscular blocking effect in patients with bilharzial liver cirrhosis. We studied 20 patients which were divided into 2 groups, 10 patients each, the patients of the first group were ASA, I or II and patients of the second group had hepatic cirrhosis child II all patients received thiopentone sodium, cisatracurium 0.1mg/kg, then intubation was done and anaesthesia was maintained with N20 O2 and halothane with controlled ventilation. There was significant prolongation in the onset time of relaxation after injection of the bolus dose in hepatic patients, however there was insignificant difference between the two groups as regard the duration of neuromascular block or total dose of cisatracurium. So, we can conclude that cisatracurium is a suitable muscle relaxant in patients with liver cirrhosis