[The effect of different priming doses on the pharmacodynamics of cisatracurium].
OBJECTIVE
The aim of the study was to evaluate the effect of two different priming regimen on the onset time of 100 micrograms/kg cisatracurium, when compared to bolus administration.


METHODS
51 patients were randomly assigned and received either a bolus of 100 micrograms/kg cisatracurium, or a priming dose of 10 micrograms/kg cisatracurium followed after 4 min by 90 micrograms/kg cisatracurium, or a priming dose of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium. The neuromuscular monitoring was performed using a mechanomyograph (Groningen II Monitor). Anaesthesia was induced with propofol and fentanyl and maintained by continuous infusion of propofol.


RESULTS
The priming combination of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium produced a statistically significant reduction in the onset time (95% block) (180 +/- 60 s) and time to complete block (210 +/- 48 s), when compared to the bolus group (240 +/- 60 s and 288 +/- 66 s) (p < 0.05).


CONCLUSIONS
Our data indicate that the "priming principle" is an appropriate technique to shorten the onset time of cisatracurium. To achieve a maximum effect the priming combination of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium is recommended.
Pühringer
F K
FK
Universitätsklinik für Anaesthesie und Allgemeine Intensivmedizin, Leopold Franzens Universität Innsbruck, Osterreich. friedrich.puehringer@uibk.ac.at
Scheller
A
A
Kleinsasser
A
A
Löckinger
A
A
Keller
P
P
Raedler
C
C
Keller
C
C
D000328:Adult; D000758:Anesthesia; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D005260:Female; D005283:Fentanyl; D006801:Humans; D008297:Male; D009213:Myography; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D015742:Propofol
D018686:Anesthetics, Intravenous; D009466:Neuromuscular Blocking Agents; D001279:Atracurium; C101584:cisatracurium; D005283:Fentanyl; D015742:Propofol