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

Comparison Of Atracurium Versus Cis-Atracurium

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 ED95 doses of cis-atracurium (100 μ 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 compared 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. [K S Natl J Integr Res Med, 2021; 12(6): 26-31]