DURATION OF INTENSE PARALYSIS FOLLOWING INDUCTION OF NEUROMUSCULAR BLOCKADE USING CISATRACURIUM VS ATRACURIUM AS ASSESSED BY TRAIN OF FOUR STIMULATION: A PROSPECTIVE RANDOMISED COMPARATIVE DOUBLE BLIND STUDY

Dr T. S. Ambujam, Dr Renu Devaprasath, Dr Alex Francisco Nicholas, Dr Jeyanthan T, Dr Syed Rubiya Sultana

Abstract


BACKGROUND:

 This study was undertaken to determine the duration of intense muscle paralysis after the initial paralyzing dose of Cisatracurium and Atracurium which are intermediate acting non-depolarizing neuromuscular blocking agents.

METHODS:

After obtaining informed consent, 84 ASA 1 and 2 patients, 18 to 58 years scheduled for elective surgery under general anaesthesia with paralysis were included in the study. Patients were randomized to receive either Atracurium 0.5 mg /kg or Cisatracurium 0.1 mg /kg to facilitate tracheal intubation. Premedication and induction were similar for all patients .The duration of intense paralysis was assessed by delivery of supramaximal Train Of Four (TOF) stimuli on the adductor pollicis using a peripheral nerve stimulator.The time between disappearance of the response and reappearance of the first twitch in TOF was taken as the duration of intense paralysis.

RESULTS:

 There was a statistically significant difference in the duration of intense paralysis between the two drugs. The duration of intense paralysis of Cisatracurium was longer than Atracurium with no statistical difference in onset of action.

CONCLUSION:

    Although both Atracurium and Cisatracurium are intermediate acting non-depolarizing drugs Cisatracurium provides longer duration of intense paralysis than Atracurium.

Keywords


Atracurium, Cisatracurium, Train Of Four

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