title: The infusion requirements and recovery characteristics of cisatracurium or atracurium in intensive care patients.
abstract: OBJECTIVE
  To investigate the infusion requirements and recovery characteristics of cisatracurium compared with atracurium when both are administered by prolonged continuous infusion.
  
  
  METHODS
  A prospective, randomised, single-blind study.
  
  
  METHODS
  The Intensive Care Unit of the Manchester Royal Infirmary.
  
  
  METHODS
  20 patients requiring a continuous infusion of a neuromuscular blocking agent to facilitate mechanical ventilation. 12 patients received cisatracurium and 8 received atracurium.
  
  
  METHODS
  Cisatracurium or atracurium was administered by continuous infusion for a minimum of 24 h. The level of neuromuscular blockade was measured by recording the train-of-four responses using acceleromyography, the aim being to maintain 1-2 twitch responses of the adductor pollicis. At the end of the infusion period, the train-of-four was recorded until the ratio was greater than 0.7.
  
  
  RESULTS
  The mean infusion rate of cisatracurium was 0.23 mg kg-1 h-1, compared to 0.62 mg kg-1 h-1. No time-related increase in infusion requirements was seen for either drug. The mean recovery time to a train-of-four ratio greater than 0.7 was the same (46 min). There was no correlation between recovery time and age, duration of infusion or mean infusion rate.
  
  
  CONCLUSIONS
  Cisatracurium provides a satisfactory level of neuromuscular blockade in adult ICU patients at approximately one-third the infusion rate of atracurium and with a similar recovery time.
authors.affiliation: University Department of Anaesthesia, Manchester Royal Infirmary, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Pearson
authors.forename: N J
authors.initials: NJ
authors.lastname: Harper
authors.forename: B J
authors.initials: BJ
authors.lastname: Pollard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001279:Atracurium / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D003422:Critical Care; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D012121:Respiration, Artificial; D016037:Single-Blind Method; D013997:Time Factors
chemical_list: D009466:Neuromuscular Blocking Agents; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; C101584:cisatracurium