title: Influence of the priming technique on pharmacodynamics and intubating conditions of cisatracurium.
abstract: OBJECTIVE
  To determine the effects of the priming technique on the intubating conditions and pharmacodynamics of different doses of cisatracurium.
  
  
  METHODS
  Open-label, randomized study.
  
  
  METHODS
  Operating room of a university-affiliated hospital.
  
  
  METHODS
  60 ASA physical status I, II, and III female patients.
  
  
  METHODS
  Patients were randomly assigned to one of four groups. Patients from Groups 1, 2, and 3 received 0.01 mg/kg cisatracurium as a priming dose, and patients from Group 4 received placebo. Four minutes later, patients from Groups 1, 2, 3, and 4 received the following intubating doses of cisatracurium: 0.09 mg/kg, 0.14 mg/kg, 0.19 mg/kg, and 0.2 mg/kg, respectively. Anesthesia was induced with thiopental sodium, sufentanil, droperidol, and nitrous oxide (N2O; 6 L/min) in oxygen (O2; 4 L/min) and maintained with isoflurane up to 0.7%, N2O in O2, and sufentanil. Mechanomyography assessed the neuromuscular function of the adductor pollicis with train-of-four supramaximal impulses. The trachea was intubated when the amplitude of the first twitch decreased to 10% to 15% of control.
  
  
  RESULTS
  There were no significant differences among the groups regarding the demographic data, the value of the first twitch at 60 seconds, the time to 90% block, and the onset time. Clinical duration of cisatracurium was significantly different between Group 3 and Groups 1 and 2, whereas Group 4 differed significantly from Group 1. Intubating conditions did not differ significantly among the groups.
  
  
  CONCLUSIONS
  When primed, cisatracurium 0.09 mg/kg and 0.14 mg/kg produced an onset time comparable with that of 0.2 mg/kg and allowed an earlier spontaneous recovery (p < 0.05). In this study, there was no benefit in priming cisatracurium 0.19 mg/kg.
authors.affiliation: Department of Anesthesiology, University of Miami/Jackson Memorial Medical Center, FL 33101, USA.
authors.forename: K
authors.initials: K
authors.lastname: Deepika
authors.forename: C A
authors.initials: CA
authors.lastname: Kenaan
authors.forename: G B
authors.initials: GB
authors.lastname: Bikhazi
authors.forename: D B
authors.initials: DB
authors.lastname: Martineau
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects; D018482:Muscle, Skeletal / Q000187:drug effects / Q000503:physiopathology; D009213:Myography; D019148:Neuromuscular Blockade; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage* / Q000494:pharmacology; D010919:Placebos; D011229:Preanesthetic Medication; D013997:Time Factors; D014459:Ulnar Nerve / Q000187:drug effects / Q000503:physiopathology
chemical_list: D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D009466:Neuromuscular Blocking Agents; D010919:Placebos; D001279:Atracurium; C101584:cisatracurium