Efficacy of 4×ED95 Loading Dose of Cisatracurium Besylate for Endotracheal Intubation – A Clinical Study

Loading Dose of Cisatracurium Besylate for Endotracheal Intubation

Abstract

Background: Cisatracurium besylate is the latest addition in the list of non-depolarizing neuromuscular blocking drugs. It has some very agreeable properties in terms of high potency with intermediate duration of action; but almost negligible production of Laudanosine, no histamine release and a major non-hepatic non-renal elimination. Various studies undertaken comparing different doses of Cisatracurium show that the dose for adequate intubating conditions lies between 0.15mg/kg to 0.2mg/kg. Since 0.2mg/kg (4D95) has been reported to have more haemodynamic stability, we decided to study its effects in terms of onset, intubating conditions, duration of action, reversibility and histamine release. Subjects and Methods: This study was conducted on 30 randomly selected patients of either sex between the ages of 18-60 years, undergoing elective surgical procedures under general anaesthesia with endotracheal intubation. All the patients were anaesthetized following standard and identical anaesthetic technique. Endotracheal intubation was facilitated with 0.2mg/kg of Inj.Cisatracurium. The quality of muscle relaxation was assessed purely on clinical observations. Results: With 4D95 dose we achieved excellent to good laryngoscopic view in almost all of our subjects within 3 minutes. All the patients had either excellent or good intubating conditions. Cisatracurium produced intermediate duration of action. The muscle relaxation produced by Cisatracurium was easily reversed with Neostigmine. There was no clinical evidence of histamine release.  Conclusion: Cisatracurium in 2mg/kg (4D95) loading dose is an effective neuromuscular blocking agent devoid of histamine release.