Abstract

The principal uses of neuromuscular blocking drugs are to provide skeletal muscle relaxation to facilitate tracheal intubation and to improve surgical working conditions during general anesthesia. Present study was aimed to compare of hemodynamic stability and neuromuscular blockade of cisatracurium at a higher dose (6×ED95) versus recommended intubating dose (2×ED95) of atracurium in patients undergoing elective abdominal surgery. Material and Methods: Present study was single-center, prospective, comparative study, conducted patients of age 20-65 years, either gender, American Society of Anesthesiologist Grade I & II, posted for abdominal surgeries. Results: In present study, 60 patients were randomly divided into two groups of 30 each as Group A included patients receiving Inj. Atracurium, Loading dose: 0.5mg/kg Incremental dose: 0.125mg/kg & group C: Included patients receiving Inj. Cisatracurium, loading dose: 0.3mg/kg Incremental dose: 0.025mg/kg. The mean time taken for maximal depression of twitch was 174.00±13.02 and 122.33±13.82 seconds in group A and C respectively. The difference between the two groups was strongly significant statistically (p<0.001), with Cisatracurium having an earlier onset of muscle relaxation compared to Atracurium. Excellent intubating conditions were observed in 46.7% and 83.3% of patients in Group A and C respectively, difference was statistically significant. The mean duration of action of loading dose was 39.50±2.91 and 71.20±3.88 minutes in Group A and C respectively, difference was statistically significant. Only two patients in Atracurium group had signs of histamine release in the form of flushing at the site of injection in the forearm, whereas no patients in Cisatracurium group showed signs of histamine release. The difference was however statistically insignificant. Conclusion: Cisatracurium, though more costly, is more effective and a better isomer of Atracurium.

Description