Prospective Clinical Comparative Assessment of Intubating Conditions and Neuromuscular Blocking Effects of Two Different Doses of Cisatracurium.
Intubating Conditions and Neuromuscular Blocking Effects of Cisatracurium
Background: To study the effects of two different doses of cisatracurium 0.15mg/kg and 0.2mg/kg regarding intubating conditions, duration of action, hemodynamic stability and allergic reactions.Subjects and Methods:60 patients posted for elective surgical procedures under general anaesthesia in various surgical disciplines were enrolled into the study and alternatively allocated patients into one of the two study groups of 30 each to receive either 0.15mg/kg or 0.2mg/kg of cisatracurium. Intubating conditions assessed as excellent, good, poor or not possible and duration of action assessed and noted. PR and BP monitored at regular timed intervals following muscle relaxant and allergic reactions evaluated clinically.Results:4×ED 95 dose of cisatracurium had statistically significantly longer duration of action and had produced proportionately excellent intubating conditions as compared to its 3×ED 95 dose. The mean duration of action after 4×ED 95 loading dose was 53.03±5.75 minutes and 45.16±4.41 minutes after 3×ED 95 dose and the difference was statistically and clinically significant. Proportionately 4×ED 95 dose of Cisatracurium had produced excellent intubating conditions as compared to its 3×ED 95 dose (90% vs 70%). Differences in hemodynamic changes (pulse rate and blood pressure) after the above doses were clinically insignificant. And none of the patients after either dose showed allergic reactions.Conclusion:Cisatracurium at a higher dose 0.2mg/kg (4×ED 95) as compared to its lower dose 0.15mg/kg (3×ED 95) provides longer duration of action and proportionately excellent intubating conditions. Both doses produced stable hemodynamic status without clinically significant changes in PR and BP. No allergic reactions were noted at both the doses.