Influence of the priming technique on pharmacodynamics and intubating conditions of cisatracurium.
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.
Deepika
K
K
Department of Anesthesiology, University of Miami/Jackson Memorial Medical Center, FL 33101, USA.
Kenaan
C A
CA
Bikhazi
G B
GB
Martineau
D B
DB
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
D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D009466:Neuromuscular Blocking Agents; D010919:Placebos; D001279:Atracurium; C101584:cisatracurium