title: Cisatracurium or rocuronium versus rocuronium-cisatracurium combination.
abstract: The present report evaluates the incidence of pain on intravenous injection and the condition of tracheal intubation at one minute following the administration of cisatracurium or rocuronium versus rocuronium-cisatracurium combination. We studied 60 patients, ASA 1, aged 18-60 years, undergoing elective surgical procedures. The patients were randomly assigned to 3 groups who received intravenously either 0.15 mg/kg cisatracurium [2ED95], 0,6 mg rocuronium [2ED95] or a combination of 0.075 mg/kg cisatracurium [1ED95], plus 0.3 mg rocuronium [1ED95]. In the awake patients, the pain on injection of muscle relaxant was assessed on a four point scale (none, mild, moderate, severe). Administration of the relaxant was followed by 1-2 mg/kg of lidocaine and 2 mg/kg propofol. Orotracheal intubation was performed 60 seconds following the administration of the relaxant. The intubating conditions were assessed and rated as excellent, good, fair or poor. The administration of 2ED95 cisatracurium resulted in poor intubating conditions at 60s, without pain on injection. In contrast, the administration of 2ED95 rocuronium resulted in excellent or good intubating conditions at 60s associated with high incidence of pain on injection in most of the patients. However, the combination of 1ED95 cisatracurium with 1ED95 rocuronium provided similar intubating conditions to the 2ED95 rocuronium alone, associated with a significantly less pain on injection.
authors.affiliation: Department of Anaesthesiology, Sahel General Hospital, Beirut, Lebanon. doczeidan@hotmail.com
authors.forename: Ahed
authors.initials: A
authors.lastname: Zeidan
authors.forename: Nazih
authors.initials: N
authors.lastname: Nahle
authors.forename: Hilal
authors.initials: H
authors.lastname: Maaliki
authors.forename: Anis
authors.initials: A
authors.lastname: Baraka
mesh_terms: D000293:Adolescent; D000328:Adult; D000732:Androstanols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019162:Anesthetics, Combined / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D001279:Atracurium / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D007442:Intubation, Intratracheal / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D015742:Propofol / Q000008:administration & dosage; D000077123:Rocuronium; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000732:Androstanols; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D009466:Neuromuscular Blocking Agents; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D008012:Lidocaine; C101584:cisatracurium; D000077123:Rocuronium; D015742:Propofol