Comparative study to evaluate equipotent doses of cisatracurium and atracurium in patients undergoing abdominal laparoscopic surgery
Abstract
Background & objectives: Muscle relaxant make an important part of the balanced anesthesia, especially for abdominal surgery. Over a period of time, newer relaxants have been developed with lower side effects and better recovery profile. This study compared two relaxants – cisatracurium and atracurium, as a part of general anesthesia for the laparoscopic medical procedures.
Methodology: A total of 120 patients, 18-60 y of age, scheduled for the laparoscopic cholecystectomy were selected. Patients were randomly divided into two groups; Group C received cisatracurium 0.1 mg/kg as muscle relaxant and Group A received atracurium 0.3 mg/kg IV. The mean onset time and duration of action for the two groups was done by Stockholm rules of the pharmacodynamic investigations of muscle relaxants activity. Intubating conditions, hemodynamic changes, and safety profile were noted.
Results: The mean onset time was 4.04 ± 0.28 min vs. 5.12 ± 0.42 min for cisatracurium and atracurium respectively. The mean duration of action was 42.21 ± 1.71 min vs. 51.23 ± 6.1 min for cisatracurium and atracurium respectively (p < 0.001). Intubating conditions, hemodynamic changes, recovery time and safety profile were comparable between the groups. Recovery time following administration of cholinesterase inhibitors were 4.27 ± 0.23 vs. 3.24 ± 0.36 min (p < 0.001)in the cisatracurium and atracurium group respectively.
Conclusion: Cisatracurium has a quicker onset time and provides better conditions for tracheal intubation, compared to atracurium. Cisatracurium was demonstrated to have a better safety profile than atracurium.
Abbreviations: BMI – Body mass index; MAC – Minimum alveolar concentration; NMBD – Neuromuscular blocking drug; NMJ – Neuromuscular junction
Key words: Cisatracurium, atracurium, neuromuscular blockade, neuromuscular monitoring.
Citation: Narang D, Chaurasia A, Kumar G, Upadhyay MK. Comparative study to evaluate equipotent doses of cisatracurium and atracurium in patients undergoing abdominal laparoscopic surgery. Anaesth. pain intensive care 2021;25(5):667–671; DOI: 10.35975/apic.v25i5.1618
Received: March 20, 2021, Reviewed: April 11, 2021, Accepted: April 19, 2021
