Evaluation of cisatracurium, a new neuromuscular blocking agent, for tracheal intubation

Bluestein, Linda S.; Stinson, Lawrence W.; Lennon, Robert L.; Quessy, Stephen N.; Wilson, Rebecca M.

doi:10.1007/bf03011806

Cited by 59 publications

(55 citation statements)

References 14 publications

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“…In this study, the onset of action of cisatracurium was signifi cantly lower in the propofol group than in the etomidate group (86.6 ± 14.3 vs 116, 9 ± 11.6 s). These results differ from those described by Bluestein et al 11 , who evaluated the effects of propofol as a hypnotic agent and cisatracurium at varying doses and different times for tracheal intubation. The authors reported that cisatracurium (0.1 mg.kg -1 ) had an onset of action of 4.6 minutes, and tracheal intubation conditions after 2 minutes of injection of NMB were good or excellent in 89% of patients.…”

Section: Discussioncontrasting

confidence: 99%

“…In clinical practice, the desirable characteristics in selecting a neuromuscular blocker are hemodynamic stability, rapid onset of action, and ability to provide adequate muscle relaxation to enable laryngoscopy and tracheal intubation 11 . Cisatracurium is one of the 10 isomers of atracurium, with ED 95 of 0.05 mg.kg -1 in balanced anesthesia, without cardiovascular effects due to histamine release, which is an important advantage over atracurium 11,12 .…”

Section: Discussionmentioning

confidence: 99%

“…Cisatracurium is one of the 10 isomers of atracurium, with ED 95 of 0.05 mg.kg -1 in balanced anesthesia, without cardiovascular effects due to histamine release, which is an important advantage over atracurium 11,12 . This study evaluated the onset of action, tracheal intubation conditions, and hemodynamic repercussions of cisatracurium with a dose corresponding to two ED95, using propofol or etomidate as hypnotic agents during anesthesia induction, as installation of neuromuscular block and tracheal intubation conditions are infl uenced by effects intrinsic to the hypnotic agent used in anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Excellent and good scores are considered indicative of clinically acceptable conditions for tracheal intubation, but it depends on the skill of the professional performing tracheal intubation, depth of anesthesia, and degree of neuromuscular block 1,11 . Thus, it is diffi cult to assess the pharmacodynamic properties of neuromuscular blockers considering only the intubation conditions.…”

Section: Discussionmentioning

confidence: 99%

“…However, it has drawbacks, such as a greater risk of cardiovascular effects, besides prolonged blockade 11,27,28 . Although one of the adverse effects of propofol is reduced cardiac index and systemic vascular resistance with consequent hypotension 29 , there were no signifi cant changes in the hemodynamic parameters of both groups in the present study that could have infl uenced the neuromuscular block.…”

Section: Discussionmentioning

confidence: 99%

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Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

Braga¹,

Braga²,

Potério³

et al. 2013

Rev. Bras. Anestesiol.

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Background and objective: Different drugs, including hypnotics, may infl uence the pharmacodynamic effects of neuromuscular blockers (NMB). The aim of this study was to evaluate the infl uence of propofol and etomidate on cisatracurium-induced neuromuscular blockade. Method: We included 60 patients, ASA I and II, undergoing elective surgery under general anesthesia in the study and randomly allocated them into two groups, according to their hypnotic drug: GI (propofol) and GII (etomidate). Patients received intramuscular (IM) midazolam (0.1 mg.kg ). The patients were ventilated with 100% oxygen until obtaining a reduction of 95% or more in the adductor pollicis response amplitude, with subsequent laryngoscopy and tracheal intubation. Neuromuscular function was monitored by acceleromyograhpy. We evaluated the onset of action of cisatracurium, tracheal intubation conditions, and hemodynamic repercussions. Results: The mean time and standard deviations of cisatracurium onset were: GI (86.6 ± 14.3 s) and GII (116.9 ± 11.6 s), with a signifi cant difference (p < 0, 0001). Intubation conditions were acceptable in 100% of GI and 53.3% of GII patients (p < 0.0001). Conclusion: Induction of neuromuscular blockade with cisatracurium was faster, with better intubation conditions in patients receiving propofol compared to those receiving etomidate, without hemodynamic repercussions.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

Braga¹,

Braga²,

Potério³

et al. 2013

Rev. Bras. Anestesiol.

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Increased cis-atracurium requirements during prolonged administration to a child

Tobias

1997

Can J Anaesth

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Purpose: To report increased infusion requirements of ds-atracurium during prolonged infusion (six weeks) to provide neuromuscular blockade in a child during prolonged mechanical ventilation, Despite a previous study in adult patients which demonstrated no increase in infusion requirements over five days, we noted a considerable increase over six weeks.Clinical features: A seven month old infant required prolonged mechanical ventilation and neuromuscular blockade following an episode of multi-system organ failure from pseudomembranous colitis. The infusion of cisatracudum was adjusted according to the train-of-four response obtained with a peripheral nerve stimulator using standard train-of-four monitoring. Initial infusion requirements which were 2.8 gg-kg -I min -~ on day #1 increased to 22.3/Jg.kg -~ min -I on day #40. Gondusion: Increased infusion requirements were necessary during ~he prolonged adminisb-~on of cisatracurium to a critically ill infant. YCration of the dose based on monitoring with a peripheral nerve stimulator is recommended.Objcctif : Rapporter I'augmentation des besoins de cis-atraoJrium pendant une perfusion de Iongue durEe (six semaines) utilisEe pour curariser un enfant pendant la ve~lation nr~anique. MalgrE une Etude antEdeure qui dErnontrait chez les adultes une augmentation importante des besoins suntenant en cinq jours, ici, I'importante augmentation a EtE constatEe en six semaines. ~h~menll~ dimques : Un enfant de sept mois a eu besoin de ventilation rnEc~ique prolongEe avec curarisation ~1 la suite d'une dEPaillance muitivisc&ale causEe par une colite ~use.La perfusion de dsatracurium c~tait rc~gl~r' e selon la nL~:)nse au train-de-quatre monitortr, e ave(: un stimulateur nerveux pEriphErique, Les besoins initiaux de la perfusion qui Etaient de 2,8/Jg.kg "1 min -j sont pass~ ~ 22 ,ug.kg -i min -I ~ la quarantiEme joumEe. Gondusion : II a EtE n&essaire d'augmenter une perfusion de cis-atracurium de Iongue durvae chez un enfant gravernent malade. II est recommandE d'ajuster la dose de curare ave(: un moniteur I~ripl~rique pour le bloc neuromusculaire.

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Primingtechnik mit Cisatracurium

et al. 2007

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Evaluation of cisatracurium, a new neuromuscular blocking agent, for tracheal intubation

Abstract: Evaluation

Cited by 59 publications

References 14 publications

Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

Increased cis-atracurium requirements during prolonged administration to a child

Primingtechnik mit Cisatracurium

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