Developing countries with higher prevalence of RHD encounter cases of AF in pregnancy. Szekely et al reported new onset of AF in 8% of pregnant patients with RHD.1 Dilatation of LA, elevated LA pressure and myocardial stretch due to mitral valve disease results in slow conduction velocities, increased dispersion of refractoriness and automaticity leading to AF. Occurrence is common in third trimester due to Increased HR, cardiac output, heart size, plasma volume, wall tension and decreased SVR. AF intensifies hemodynamic changes and predisposes to heart failure.2

Introduction: Cisatracurium, a Benzyl-iso-quinolinium compound is a non-depolarizing muscle relaxant with intermediate duration of action. The ED95 dose of Cisatracurium is 0.04mg/kg (0.032-0.05mg/kg).The intubating dose of a non-depolarizing muscle relaxant drug (NDMD) is 2 times ED95, but for Cisatracurium the recommended intubating dose is 0.15mg/kg which is 3 times ED 95. We did this study to compare the hemodynamic stability and ease of intubation with two different doses of Cisatracurium (0.1mg/kg and 0.15mg/kg) in patients undergoing elective surgery under general anaesthesia with regards to hemodynamic stability, intubating conditions at 3minutes of administration of the drug, requirement of additional dose to provide adequate muscle relaxation, need for drugs to suppress response to laryngoscopy and to check for signs of histamine release. Materials and Methods: 200 patients of the American Society of Anesthesiologists Grade 1 and undergoing elective surgeries under general anesthesia were taken up and divided into two groups of 100 each by computer-generated randomization. Group 1 received Inj. Cisatracurium besylate 0.15 mg/kg IV, Group 2 received Inj. cisatracurium besylate 0.1 mg/kg IV. Results: Both the groups had good to excellent intubating condition after 3 minutes of administration of the study drug.